title: Percutaneous CT-guided cryoablation of the dorsal penile nerve for treatment of symptomatic premature ejaculation.
abstract: OBJECTIVE
  To evaluate expansion of image-guided interventional cryoablation techniques usually employed for pain management to address the feasibility, safety, and efficacy of treatment for a urologic condition with otherwise limited treatment options, premature ejaculation (PE).
  
  
  METHODS
  Prospective institutional review board approval was obtained, and 24 subjects with PE were enrolled. All patients underwent unilateral percutaneous computed tomography-guided cryoablation of the dorsal penile nerve (DPN). Postprocedural intravaginal ejaculatory latency times (IELTs) and PE Profile (PEP) results served as outcome variables. In addition, subjects were asked whether they would have the procedure done again based on their experience at the 180- and 360-day marks.
  
  
  RESULTS
  The technical success rate was 100%. Baseline average IELT was 54.7 seconds ± 7.8 (n = 24), which increased to a maximum of 256 seconds ± 104 (n = 11; P = .241) by day 7 and decreased to 182.5 seconds ± 87.8 (n = 6; P = .0342) by day 90. The mean IELT remained at 182.5 seconds ± 27.6 at day 180 (n = 23; P<.0001) and decreased to 140.9 seconds ± 83.6 by 1 year (n = 22; P<.001). PEP scores improved overall, IELTs significantly improved at 180 and 360 days, and 83% of subjects reported that they would undergo the procedure again if given the same opportunity. There were no procedure-related complications.
  
  
  CONCLUSIONS
  CT-guided percutaneous unilateral cryoablation of the DPN is a feasible, safe, single-day outpatient procedure for the treatment of symptomatic PE.
authors.affiliation: Division of Vascular and Interventional Radiology, University Hospitals Case Medical Center, 11100 Euclid Ave, BSH 5056, Cleveland, OH 44106, USA. david.prologo@uhhospitals.org
authors.forename: J
authors.initials: J
authors.lastname: David Prologo
authors.forename: Laura L
authors.initials: LL
authors.lastname: Snyder
authors.forename: Edward
authors.initials: E
authors.lastname: Cherullo
authors.forename: Matthew
authors.initials: M
authors.lastname: Passalacqua
authors.forename: Ali
authors.initials: A
authors.lastname: Pirasteh
authors.forename: David
authors.initials: D
authors.lastname: Corn
mesh_terms: D000328:Adult; D003452:Cryosurgery / Q000379:methods*; D003714:Denervation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010413:Penis / Q000294:innervation* / Q000601:surgery*; D061686:Premature Ejaculation / Q000000981:diagnostic imaging / Q000601:surgery*; D025321:Surgery, Computer-Assisted / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome