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Premature ejaculation (Ejaculatio praecox)
Rapid ejaculation is a main problem of young people. It is due to somatic causes like affection of the autonomic nervous system or psychosomatic causes like anxiousness and stress conditions and partner conflicts. The cause is to some extent age dependant. The disease agonises the female partener and leads to social conflicts even between married couples.

The treatement is to perform some sexual training and positions (Masters and Johnson) to reduce the irritation of the hypersenstive glans penis. This does not always functin successfully. A second way of treatment is to give medication which reduce and delay the ejaculation. These medications have side effects on the general circulatory system and may lead to temporary loss of ejacualtion (anejaculation). Ejaculation returns when the medication is stoped without any effect of sexuality.

Recentely it was observed that the the surgical reduction of the senstivity of the glans through the separation of the fine nerve branches supplying the glans is a sucessful treament for the disease. This result is observed in patients who have good erection and positive response to the injections used to produce artificial erection. It does not work in cases of impotenece or venous leakage.

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Incision

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Who qualifies for the operation?

People who suffer under rapid ejaculation provided that they have an ntact pudendal nerve supply and good erection.

How does tha operation work?

The patient lies on his back. After desinfection, local anaesthesia is injected to render the shaft of the penis painless. A small transverse incision is done on the side of the lower part of the shaft behind the head of the penis on each side. The minute nerve fibres traversing the area are cut to reduce senstivity to the galns. The wound is closed on both sided and dressed.

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Nerve transsection
The division of the small peripheral nerve branches of the glans
is marked with red arrows.



Frequently asked questions (FAQ):

  1. Is it possible to treat rapid ejaculation with pills?
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    It is sometimes possible to do so.
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  2. What are the side effects of medical treatment?
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    These drugs affect the circulatory system and my lead to drawsness. They may also lead to lowering of the blood pressure. That is why the dose is incerased gradually over a long period of time. Lastely they may cause loss r complee absence of ejaculation.
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  3. Is loss of ejaculation due to drugs a long lasting side effect?
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    No, it is temporary. Ejaculation returns after stopage of the medication.
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  4. Is I tdangeroous to separate the nerve fibres of the glans?
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    No, only a part of it is cut on each side to render the glans less senstive. This causes delay in ejaculation.
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  5. What the effect on erection and sexual ability?
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    There is no effect.
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  6. What are the complications of the operation?
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    These are bleeding, injury to the erection body (rare), infection, injury to the urethra (rare), extensive loss of sensation and may be no effect at all.
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  7. Whaen can I perform sex after the operation?
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    It is always advisable to abstain from peneterating sex for six weeks after penile surgery to avoid any possible bleeding or infection.