Premature Ejaculation: Myths, Treatments, and Risks - Urology

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Premature ejaculation (PE) is a common condition that affects many men, and understanding its myths, treatments, and risks is crucial for effective management. Let's address your questions and concerns regarding this condition.


Myths about Premature Ejaculation
One prevalent myth is that PE is solely a psychological issue. While psychological factors such as anxiety, stress, or relationship problems can contribute to PE, it can also have physiological causes. These may include hormonal imbalances, inflammation of the prostate or urethra, or neurological conditions. Understanding that PE can arise from both psychological and physiological factors is essential for effective treatment.


Treatments for Premature Ejaculation
There are several treatment options available for PE, ranging from behavioral techniques to medications and surgical interventions.
1. Behavioral Techniques: One common method is the "stop-start" technique, where stimulation is paused before ejaculation to help increase control. Another method is the "squeeze" technique, where pressure is applied to the penis to delay ejaculation.

2. Topical Anesthetics: Creams or sprays containing numbing agents can be applied to the penis to reduce sensitivity and help delay ejaculation.

3. Medications: Selective serotonin reuptake inhibitors (SSRIs) are often prescribed off-label for PE, as they can delay ejaculation as a side effect. Other medications, such as tramadol, may also be used.

4. Surgical Options: As you mentioned, dorsal nerve resection (or dorsal nerve block) is a surgical procedure that some men consider for PE. This surgery involves cutting the dorsal nerve of the penis, which is thought to reduce sensitivity and delay ejaculation. However, this procedure is typically reserved for severe cases that do not respond to other treatments.


Risks and Considerations of Surgery
While surgical options may provide relief for some men, they come with risks. Potential complications include:
- Loss of Sensation: While the goal is to reduce sensitivity, some men may experience a loss of sensation in the penis, which could affect sexual pleasure.

- Erectile Dysfunction: There is a risk of developing erectile dysfunction post-surgery, which can be distressing.

- Infection: As with any surgical procedure, there is a risk of infection at the surgical site.

- Scarring: Surgical intervention can lead to scarring, which may affect the appearance and function of the penis.


Regarding Your Specific Questions
1. Using a Towel to Reduce Sensitivity: While some men may find that rubbing the glans (the head of the penis) with a towel or cloth can desensitize the area temporarily, this method is not scientifically validated. It could potentially cause irritation or injury if done too aggressively. If you choose to try this, use a soft towel and be gentle to avoid any damage.

2. Understanding the "3 Minutes" in Surgical Claims: The claim that surgery can delay ejaculation by a specific time, such as three minutes, is often based on subjective reports from patients. The actual effectiveness can vary significantly among individuals, and there is no standardized measure for how much longer one can expect to last post-surgery.

3. Location of the Dorsal Nerve: The dorsal nerve of the penis runs along the top side of the penis and is responsible for sensation. It branches from the pudendal nerve, which is a key nerve in the pelvic region.

4. Post-Surgery Expectations: While some men may experience improvement in their condition after surgery, it is not guaranteed that all will be free from PE. The outcomes can vary, and it’s essential to have realistic expectations and discuss them thoroughly with your healthcare provider.


Conclusion
If you are experiencing premature ejaculation, it is advisable to consult a healthcare professional who specializes in sexual health. They can provide a comprehensive evaluation and help you choose the most appropriate treatment based on your individual circumstances. Remember, effective communication with your partner and seeking support can also play a significant role in managing this condition.