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Microsurgical Denervation of the Penis for Lifelong Premature Ejaculation: A Prospective Multicenter Study Evaluating
Khaled Almekaty1, Mohamed Alhefnawy2, Ahmed Ismael1
1Urology Department, Tanta University, Tanta, Egypt.
Objective:
To prospectively assess the clinical outcomes and safety of microsurgical denervation of the penis (MSDP) for treatment of lifelong premature ejaculation (LPE); and to examine the impact of transitioning from partial to more extensive denervation.
Methods:
A prospective multicenter study including 60 men with LPE unresponsive to optimized medical treatment who underwent MSDP. The primary outcome was to assess changes in Intravaginal Ejaculatory Latency Time (IELT), Premature Ejaculation Profile (PEP), Patients' and Partners' Satisfaction scores at 1, 3, and 6 months after MSDP. The secondary outcome was to evaluate the effect of added-on medical treatment to patients who underwent MSDP without satisfactory results after 6 months.
Results:
MSDP was associated with statistically significant increases in the mean± SD IELT [from 5.4±0.3-77±22, 127±35, and 125±37, P<.001] and PEP scores [from 3±0.2-9±2.2, 12.1±2.6, and 11.5±1.9, P<.001] at 1, 3, and 6 months, and 33 (55%) were satisfied. Twenty-seven dissatisfied patients had received added-on medical therapy for 3 months. They showed a statistically significant increase in IELT [from 102±23-134±35.6, P<.001], and PEP scores [from 10.6 ±1.8-13 ± 2.3, P=.002], and 17 (63%) were satisfied. None of the patients developed permanent glans anesthesia, paresthesia, or erectile dysfunction.
Conclusion:
In selected men with LPE refractory to medical therapy, MSDP, with the protocol and technique modifications presented in the current study, appears to be a safe potential treatment option.
