A novel treatment modality in patients with premature ejaculation resistant to conventional methods: the neuromodulation of dorsal penile nerves by pulsed radiofrequency.
Premature ejaculation (PE) is the most common sexual problem experienced by men, and it affects 20%-30% of them. Pulsed radiofrequency (PRF) neuromodulation has been shown to be an effective treatment for a wide range of pain conditions. We used PRF to treat PE by desensitizing dorsal penile nerves in patients resistant to conventional treatments. Fifteen patients with a lifelong history of PE, defined as an intravaginal ejaculatory latency time (IELT) of <1 minute that occurred in more than 90% of acts of intercourse and was resistant to conventional treatments, were enrolled in this study. Patients with erectile dysfunction were excluded. The mean age of the patients was 39 +/- 9 years. Before and 3 weeks after the treatment, IELT and sexual satisfaction score (SSS; for patients and their partners) were obtained. The mean IELTs before and 3 weeks after procedure were 18.5 +/- 17.9 and 139.9 +/- 55.1 seconds, respectively. Side effects did not occur. Mean SSSs of patients before and after treatment were 1.3 +/- 0.3 and 4.6 +/- 0.5, and mean SSSs of partners before and after treatment were 1.3 +/- 0.4 and 4.4 +/- 0.5, respectively. In all cases, IELT and SSS were significantly increased (P < .05). None of the patients or their wives reported any treatment failure during the follow-up period. The mean follow-up time was 8.3 +/- 1.9 months. It is early to conclude that this new treatment modality might be used widely for the treatment of PE; however, because it is an innovative modality, placebo-controlled studies (eg, sham procedure), with larger numbers of patients and including assessment of penile sensitivity (eg, biothesiometry), are needed.
Basal
Seref
S
Department of Urology, Gülhane Military Medical Academy, School of Medicine, 06018 Ankara, Turkey. serefbasal@gmail.com
Goktas
Serdar
S
Ergin
Atilla
A
Yildirim
Ibrahim
I
Atim
Abdulkadir
A
Tahmaz
Lutfi
L
Dayanc
Murat
M
D000328:Adult; D017115:Catheter Ablation / Q000379:methods*; D004542:Ejaculation / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010413:Penis / Q000294:innervation* / Q000601:surgery*; D020018:Sexual Dysfunctions, Psychological / Q000601:surgery*; D055815:Young Adult