title: [Comparing efficacy of selective penile denervation and circumcision for primary premature ejaculation].
abstract: OBJECTIVE
  To compare the efficacy and safety of selective penile denervation to that of circumcision for primary premature ejaculation (PPE).
  
  
  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.
authors.affiliation: Department of Urology, Sechenov First Moscow State Medical University, Moscow.
authors.forename: Yu G
authors.initials: YG
authors.lastname: Alyaev
authors.affiliation: Department of Urology, Sechenov First Moscow State Medical University, Moscow.
authors.forename: N D
authors.initials: ND
authors.lastname: Akhvlediani
mesh_terms: D000328:Adult; D002944:Circumcision, Male; D003714:Denervation; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D061686:Premature Ejaculation / Q000503:physiopathology* / Q000601:surgery*
keywords: circumcision; denervation; penile neurotomy; penis; premature ejaculation