Is Nerve Microsurgery a Reliable Solution for Premature Ejaculation?

excuse me?

I have a question for the doctor: I saw a report online stating that premature ejaculation can be treated by performing a microsurgical procedure to cut a small segment of the nerves responsible for controlling ejaculation, which supposedly guarantees a 100% effectiveness in prolonging ejaculation time.
Is this surgical procedure really that miraculous? Is it truly reliable? The article was published by Dr.
Chen Jinming, the director of a plastic surgery clinic called Eden in northern Taiwan, who claims to be a former plastic surgeon at Chang Gung Memorial Hospital.
I'm unsure about the credibility of this information.
Could you please share your thoughts on this type of surgery? Thank you!

A Zhi, 30~39 year old female. Ask Date: 2005/11/17

Dr. Pan Zhenqin reply Urology

Male sexual dysfunction is a multifaceted issue, involving vascular, neurological, and psychological aspects, and premature ejaculation is no exception.
The surgical method proposed by Dr.
Chen involves microsurgically severing a portion of the nerves that innervate the glans penis and the coronal sulcus, which theoretically may reduce the sensitivity of the glans and improve the condition for some patients with premature ejaculation.
However, the severed nerves are sensory nerves, meaning that successful surgery would require adjustment to abnormal sensations in the glans, even when not in use.
Once the abnormal sensations are adapted to, the effectiveness of the surgery may be diminished.
The nerves responsible for ejaculation are part of the autonomic nervous system, not solely the sensory nerves of the glans; however, the aforementioned method may theoretically improve some cases of premature ejaculation.
As for the effectiveness and potential complications, to my knowledge, urologists rarely perform this surgery, so you may need to consult Dr.
Chen directly for more information.

Reply Date: 2005/11/17

More Info

The topic of nerve microsurgery as a treatment for premature ejaculation (PE) is indeed a controversial one. While the idea of surgically altering the nerves that control ejaculation may sound appealing to some, it is essential to approach this subject with caution and a critical mindset.

Premature ejaculation is a common condition that affects many men, and it can have various underlying causes, including psychological factors, hormonal imbalances, and neurological issues. Traditional treatments for PE often include behavioral techniques, topical anesthetics, oral medications, and counseling. These methods aim to address the psychological and physiological aspects of the condition without resorting to invasive surgical procedures.

The concept of using nerve microsurgery to treat PE involves cutting or altering the nerves responsible for ejaculation. Proponents of this method may claim that it can provide a permanent solution to the problem. However, there are several important considerations to keep in mind:
1. Lack of Robust Evidence: There is limited scientific literature supporting the efficacy and safety of nerve microsurgery for PE. Most studies on PE focus on non-invasive treatments, and surgical options are rarely discussed. The claims of 100% effectiveness should be viewed skeptically, as they may not be backed by rigorous clinical trials.

2. Potential Risks and Complications: Any surgical procedure carries inherent risks, including infection, bleeding, and adverse reactions to anesthesia. In the case of nerve surgery, there is also the possibility of unintended consequences, such as loss of sensation, erectile dysfunction, or other sexual dysfunctions. These risks must be weighed against the potential benefits.

3. Expertise and Credentials: The credibility of the medical professional performing the procedure is crucial. While the doctor mentioned in the article may have a background in plastic surgery, it is essential to consult with a urologist or a specialist in sexual medicine who has experience in treating PE. They can provide a more comprehensive evaluation and recommend appropriate treatment options based on the latest evidence.

4. Alternative Treatments: Before considering surgery, it is advisable to explore other treatment options. Behavioral techniques, such as the "stop-start" method or pelvic floor exercises, can be effective for many men. Additionally, medications like selective serotonin reuptake inhibitors (SSRIs) have been shown to delay ejaculation and may be a safer first-line treatment.

5. Psychological Factors: Many cases of PE have psychological components, such as anxiety or stress related to sexual performance. Addressing these issues through therapy or counseling can be beneficial and may lead to improved sexual function without the need for surgery.

In conclusion, while the idea of using nerve microsurgery to treat premature ejaculation may seem appealing, it is essential to approach this option with caution. The lack of substantial evidence, potential risks, and the importance of consulting with qualified specialists should guide any decision regarding treatment. It is advisable to explore non-invasive alternatives and seek professional guidance before considering surgical interventions.

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