Principle of surgery
The penile sensory pathway starts from the sensory apparatus in the penile skin, penile head, urethra and penile corpus cavernosum, and sends out nerve fibers that fuse to form the dorsal penile nerve bundle and join other nerve fibers to become the internal pubic nerve, which then ascends to the spinal cord via the dorsal root of the sacral nerve. After the receptors are activated, the pain, temperature and tactile information is transmitted to the hypothalamus and cortical layer through the dorsal penile nerve, pubic nerve, spinal cord and spinal thalamus bundle for sensation. With contact stimulation, nerve impulses from the penile skin and the penile head are transmitted through the dorsal penile nerve to initiate and maintain a reflex penile erection.
Evaluation of results
After dorsal penile nerve selective excision, the sensitivity of the penile head can be reduced, the ejaculatory stimulation threshold can be increased, the latency of ejaculation can be prolonged, and the quality of sexual life of patients can be improved. Generally, one month after the operation, more than 80% of patients have significantly prolonged sexual life and their ability to consciously control ejaculation is greatly enhanced.
Risks of surgery and clinical analysis
1. The traditional view is that premature ejaculation is mostly due to psychological causes, such as improper sexual awareness in childhood, sexual trauma, sexual guilt, lack of confidence in sexual life, etc. In recent years, many studies at home and abroad have shown that the excitability of the dorsal penile nerve in patients with premature ejaculation, especially the excitability of the sensory nerve of the penile head, is higher than normal, so that the ejaculatory latency and ejaculatory reflex arc are shorter during sexual intercourse, and the ejaculatory stimulation threshold is low, which can easily induce premature ejaculation during sexual intercourse.
2, the penile sensory pathway starts from the penile skin, the penile head, the urethra and the sensory apparatus in the penile corpus cavernosum, sending out nerve fibers to fuse to form the dorsal penile nerve bundle, joining other nerve fibers to become the internal pubic nerve, and then ascending to the spinal cord through the dorsal root of the sacral nerve, and after the receptors are activated, the pain, temperature and tactile information is transmitted to the hypothalamus and the cortical layer through the dorsal penile nerve, the pubic nerve, the spinal cord and the spinal thalamus bundle for perception.
With contact stimulation, nerve impulses from the penile skin and the penile head are transmitted through the dorsal penile nerve to initiate and maintain a reflex penile erection. Therefore, after selective penile dorsal nerve dissection, the sensitivity of the penile head can be reduced, the ejaculatory stimulation threshold can be increased, the latency of ejaculation can be prolonged, and the quality of sexual life of patients can be improved.
4, doctors found in the operation: under normal circumstances, the branches of the dorsal penile nerve should be two, but in patients with primary recalcitrant premature ejaculation, there are as many as 8-9 nerves, some even 13 or more, too many and too dense distribution of nerves in the glans coronalis, resulting in a high sensitivity to sexual stimulation, once entering the vagina or even just touching the vaginal opening, there will be a touch of the phenomenon, a leak like a note, that is, serious Premature ejaculation.
The surgical incision is very small, usually about 2CM, closed by sheep intestine suture, no need to rest after surgery, regular change of medicine, the incision is not wet, suture natural off can shower.
6.So will the operation cause impotence or male sterility?
The answer is no, because the erectile function of men is formed by the highly engorged and expanded penile corpus cavernosum under the action of hormones, which is not affected by the operation. The procedure is performed by making a superficial incision in the coronal sulcus, which does not affect the testicles or the reproductive ducts, so it does not affect the male reproductive function.
7. Is there an age limit? There should be no strict age limit, but the earlier the treatment, the better the results, preferably no older than 45 years old.
8, the surgery has not been introduced for a long time, foreign doctors began to try the surgery 7 years ago, the domestic 4 years ago, only a few hospitals can do, so it is still a cutting-edge technology, not many doctors can skillfully operate this technology, the patient must go to a regular hospital to choose a specialist with the risk of the efficacy is guaranteed.
9.Will the surgery have unexpected and serious consequences? The answer is no, the operation is carried out in a strictly sterilized operating room, basically no infection will occur after the operation, the least desirable result is that the operation is ineffective, premature ejaculation has not been improved in the slightest.
Indications for dorsal penile nerve selective excision
Primary premature ejaculation that is ineffective through various treatments and other diseases such as erectile dysfunction are excluded can be treated by dorsal penile nerve selective excision. The judgment criteria are
1, primary premature ejaculation, i.e. premature ejaculation since the first sexual intercourse.
2, No penile erectile disorder.
3. Men who lack the ability to regulate ejaculation at will and ejaculate within 2 minutes. Those who ejaculate even when the penis is inserted into the vagina, or those who ejaculate at the slightest stimulation.
4.The sexual satisfaction rate of the spouse is less than 50%.
5. Those who have high penile sensory sensitivity due to organic causes. Those who cannot control ejaculation even after ejaculation control training and conservative treatment.
The above judgment criteria require the patient to live together as husband and wife, have regular sex life, normal development of external genitalia, no abnormalities in bilateral testes, epididymis and spermatic cord on palpation, and normal prostate finger diagnosis. The urinary routine and prostate routine examination are normal, as well as no other contraindications to surgery.