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手术治疗早泄:叙述性综述。

Surgical treatment of premature ejaculation: a narrative review.

机构信息

Department of Urology, Tekirdag City Hospital, Tekirdag, Turkey.

Department of Urology, Selcuk University School of Medicine, Konya, Turkey.

出版信息

Int J Impot Res. 2024 Aug;36(5):474-479. doi: 10.1038/s41443-023-00771-9. Epub 2023 Oct 5.

DOI:10.1038/s41443-023-00771-9
PMID:37798540
Abstract

Recurrence after drug cessation is the biggest drawback of medical premature ejaculation (PE) treatments. Although these treatments are demonstrated to be safe and effective, most of the PE patients are interested in a more permanent solution. Despite the fact that currently available guidelines do not recommend surgical treatment for PE, some surgical interventions have been commonly performed for many years, especially in the Asian countries. The main purpose of these surgical treatments is to decrease the sensitivity of the glans penis. However, they are associated with irreversible complications such as penile deformity, sensory loss and erectile dysfunction. The aim of this narrative review is to summarize the advantages and disadvantages of various surgical interventions introduced for the treatment of PE. PubMed, Scopus and Web of Science have been utilized to search articles about glans penis augmentation and penile dorsal nerve interventions. A total of 11 articles were included, three articles excluded because they were in non-English languages. Glans penis augmentation offered a less invasive treatment that avoids severe side effects but requires retreatment in time. Selective dorsal neurectomy provided a more invasive but curative treatment alternative. However, more clinical data are necessary before surgical treatment options can be recommended to patients with PE.

摘要

停药后复发是医学性早泄 (PE) 治疗的最大缺点。尽管这些治疗方法已被证明是安全有效的,但大多数 PE 患者更希望寻求一种更持久的解决方案。尽管目前的指南不建议对 PE 进行手术治疗,但多年来一直有一些手术干预措施被广泛应用,尤其是在亚洲国家。这些手术治疗的主要目的是降低龟头的敏感度。然而,它们与不可逆转的并发症有关,如阴茎畸形、感觉丧失和勃起功能障碍。本综述的目的是总结各种用于治疗 PE 的手术干预措施的优缺点。我们使用 PubMed、Scopus 和 Web of Science 搜索了关于龟头增大和阴茎背神经干预的文章。共纳入 11 篇文章,3 篇因语言非英语而排除。龟头增大术是一种侵袭性较小的治疗方法,可以避免严重的副作用,但需要及时进行再次治疗。选择性背神经切除术提供了一种更具侵袭性但更有效的治疗选择。然而,在向 PE 患者推荐手术治疗方案之前,还需要更多的临床数据。

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Transl Androl Urol. 2024 Oct 31;13(10):2338-2350. doi: 10.21037/tau-24-204. Epub 2024 Oct 28.

本文引用的文献

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A novel on-demand therapy for lifelong premature ejaculation using a miniature transperineal electrical stimulator-the vPatch: an as-treated analysis.一种使用微型经会阴电刺激器(vPatch)治疗终身性早泄的新型按需治疗方法:一项实际治疗分析。
J Sex Med. 2023 Jan 14;20(1):22-29. doi: 10.1093/jsxmed/qdac012.
2
Current and emerging treatment options for premature ejaculation.早泄的当前和新兴治疗选择。
Nat Rev Urol. 2022 Nov;19(11):659-680. doi: 10.1038/s41585-022-00639-5. Epub 2022 Aug 25.
3
Correlation between age and curative effects of selective dorsal neurectomy for primary premature ejaculation.
选择性脊神经后根切断术治疗原发性早泄的年龄与疗效相关性研究。
Adv Clin Exp Med. 2022 Aug;31(8):837-845. doi: 10.17219/acem/147426.
4
Disorders of Ejaculation: An AUA/SMSNA Guideline.射精障碍:AUA/SMSNA 指南。
J Urol. 2022 Mar;207(3):504-512. doi: 10.1097/JU.0000000000002392. Epub 2021 Dec 28.
5
European Association of Urology Guidelines on Sexual and Reproductive Health-2021 Update: Male Sexual Dysfunction.欧洲泌尿外科学会 2021 年性与生殖健康指南更新:男性性功能障碍。
Eur Urol. 2021 Sep;80(3):333-357. doi: 10.1016/j.eururo.2021.06.007. Epub 2021 Jun 26.
6
Efficacy and Safety of Penile Girth Enhancement Using Hyaluronic Acid Filler and the Clinical Impact on Ejaculation: A Multi-Center, Patient/Evaluator-Blinded, Randomized Active-Controlled Trial.使用透明质酸填充剂增大阴茎周长的疗效与安全性及其对射精的临床影响:一项多中心、患者/评估者双盲、随机活性对照试验。
World J Mens Health. 2022 Apr;40(2):299-307. doi: 10.5534/wjmh.210007. Epub 2021 May 7.
7
Transcutaneous functional electrical stimulation-a novel therapy for premature ejaculation: results of a proof of concept study.经皮功能性电刺激治疗早泄:概念验证研究的结果。
Int J Impot Res. 2020 Jul;32(4):440-445. doi: 10.1038/s41443-019-0207-y. Epub 2019 Sep 30.
8
Transcutaneous electric nerve stimulation to treat patients with premature ejaculation: phase II clinical trial.经皮神经电刺激治疗早泄患者:Ⅱ期临床试验。
Int J Impot Res. 2020 Jul;32(4):434-439. doi: 10.1038/s41443-019-0196-x. Epub 2019 Sep 24.
9
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Int J Impot Res. 2020 May;32(3):352-357. doi: 10.1038/s41443-019-0188-x. Epub 2019 Sep 3.
10
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Andrologia. 2019 Sep;51(8):e13298. doi: 10.1111/and.13298. Epub 2019 Apr 25.