Comparing efficacy of selective penile denervation and circumcision for primary premature ejaculation


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Abstract

Objective: To compare the efficacy and safety of selective penile denervation to that of circumcision for primary premature ejaculation (PPE). Materials and methods. A prospective study comprised 138 patients with PPE, divided into two groups. Patients in Group 1 (n=50) underwent selective penile denervation by dissecting about a half of dorsal penile nerve branches. Large nerves (> 2 mm) were subjected to microsurgical neurorrhaphy. In group 2 (n=88) circumcision was carried out using guillotine technique. The evaluation of treatment efficacy was carried out using the Criteria for premature ejaculation questionnaire (CriPE), measuring intravaginal ejaculation latency time (IELT) with a stopwatch and testing penile vibration sensitivity. These examinations were performed at baseline and after 2, 4, 6, 8, 10 and 12 months after operation. Results. By the end of follow-up, 88% and 10.2% of patients of group 1 and group 2 had no signs of PPE, respectively. At 12 months IELT index increased 6-fold in patients of group 1 from 53,6±12,7 to 335,6±81,5 seconds, while remaining unchanged in group 2 with 51,8±10,4 seconds at baseline and 53.9±20.1 seconds at the end of follow-up. Group 1 showed statistically significant and sustained reduction in penile vibration sensitivity compared with baseline (p<0,001). In group 2, the baseline and endpoint characteristics of bio-tensiometry did not differ significantly (p>0,05). Conclusions. The resulting effectiveness of selective penile denervation and circumcision for PPE was 88% and 10.2%, respectively, with comparable safety.

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About the authors

Yu. G Alyaev

Sechenov First Moscow State Medical University

Email: ugalyaev@mail.ru
Department of Urology

N. D Akhvlediani

Sechenov First Moscow State Medical University

Email: nikandro@mail.ru
MD, PhD in Medical Sciences, professor at the urological department

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