Department of Urology, Tekirdag City Hospital, Tekirdag, Turkey.
Department of Urology, Selcuk University School of Medicine, Konya, Turkey.
Int J Impot Res. 2024 Aug;36(5):474-479. doi: 10.1038/s41443-023-00771-9. Epub 2023 Oct 5.
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.
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。