Premature ejaculation is one of the most common sexual health problems men face and can negatively affect both an individual's self-esteem and couple relationships. Fortunately, thanks to modern medicine and psychological approaches, premature ejaculation is now a manageable condition. In this article, after briefly discussing the causes of premature ejaculation, we will examine the effective treatment methods used in detail.
Surgical Methods in Premature Ejaculation Treatment
Although behavioral, psychological and drug treatments are usually at the forefront in the treatment of premature ejaculation, in some cases, surgical methods can also be considered as an alternative solution. Surgical interventions may be considered especially in cases of premature ejaculation that do not respond to other treatment options or develop due to an anatomical problem.
One of the most common surgical treatments is partial amputation of the penile nerves. In this operation, some of the nerves that trigger the ejaculation reflex are deactivated in order to reduce hypersensitivity in the glans penis. In this way, ejaculation time can be prolonged and the quality of sexual intercourse can be improved. However, the permanent effects and possible risks of this method should be taken into consideration and should only be preferred after an evaluation by a specialist urologist.
Another surgical option is to reduce the sensitivity of the glans penis by subcutaneous injection of filler. This technique is preferred by some patients due to its non-invasive nature and short recovery period.
Selective Dorsal Neurosectomy (SDN)
Selective Dorsal Neurosectomy (SDN) surgery is a method to reduce sensitivity, which stands out among surgical options in the treatment of premature ejaculation. This method, which is especially evaluated for men who do not respond to drug treatments or other alternative solutions, aims to control premature ejaculation caused by hypersensitivity in the glans penis.
In SDN surgery, certain parts of the dorsal nerves to the glans penis are carefully cut to reduce sensory transmission. This can help prolong the duration of intercourse by delaying the ejaculatory reflex. The operation is performed under a microscope using a very precise surgical technique. Since only certain branches of the nerves are removed during the procedure, not the entire nerve, penile sensation is not completely lost, but the level of overstimulation is reduced.
This method can give effective results especially in cases of primary (congenital) premature ejaculation. However, it may not be suitable for every patient; therefore, a detailed evaluation by a urologist is essential before surgery.
Surgical Cutting of the Nerve Endings of the Penis
Surgical cutting of the penile nerve endings is one of the advanced surgical methods used in the treatment of premature ejaculation. In this procedure, some of the nerve endings to the genital area are carefully cut or deactivated in order to reduce hypersensitivity in the glans penis. This intervention aims to delay the ejaculation reflex and prolong the duration of sexual intercourse.
However, this method is not suitable for all patients and should only be considered in men with advanced premature ejaculation who do not respond to other treatment methods. The procedure is performed with microscopic surgical technique and possible risks may include loss of sensation, infection and decreased sexual pleasure. Therefore, surgical amputation of penile nerve endings should only be recommended by experienced urologists and after detailed evaluations.
Combined Surgical Interventions (Premature Ejaculation + Erectile Dysfunction)
In some men, premature ejaculation may be accompanied by erectile dysfunction, which can seriously affect quality of life. In such cases, treatments that focus on a single problem may be inadequate, so combined surgical interventions that aim to both increase ejaculation control and improve erection quality come into play. These interventions usually involve erection-supportive surgery, such as penile prosthesis placement, along with procedures that reduce nerve sensitivity.
Combined surgical treatments are planned with a multidisciplinary approach after a comprehensive evaluation process. Successful results can be obtained especially in patients who do not respond to drug treatments and who have sexual dysfunction due to structural problems. However, like any surgical intervention, these operations have risks and recovery processes, so the treatment must be planned individually by a specialist urological surgeon.
Surgical Treatment Process and Recovery
When surgical method is preferred in the treatment of premature ejaculation, the process is planned according to the general health status of the patient, the severity of the problem and the type of operation chosen. Before the operation, a detailed urological evaluation is performed, necessary tests are requested and the patient's expectations are clarified. The procedure is usually performed under local or general anesthesia using microscopic surgical techniques. Although the operation time is short, the success rate may vary depending on the surgeon's experience and the patient's condition.
The healing process after surgery may vary from person to person, but is usually completed within a few weeks. During this period, patients should rest as recommended by the doctor, temporarily abstain from sexual intercourse and keep regular check-ups. While effects such as mild pain, bruising or temporary loss of sensation are considered normal, a physician should be consulted in case of prolonged complaints. After a correctly applied surgical treatment, a significant increase in both ejaculation control and quality of sexual life can be achieved.
Risks and Complications of Surgical Interventions
As with any surgical procedure, surgical interventions in the treatment of premature ejaculation carry certain risks and complications. The most common side effects include pain, swelling, bruising and temporary loss of sensation in the operation area. Especially in cases where nerve tissues are interfered with, partial or permanent decreased sensitivity may occur in the glans penis. While this may be positive for some patients, for others it may cause negative effects in the form of decreased sexual pleasure.
In more rare cases, surgical complications such as infection, bleeding, delayed wound healing or scar tissue formation may develop. In addition, in case of surgeon inexperience or wrong patient selection, the desired result may not be achieved. For this reason, it is of great importance that the risks are clearly understood, a detailed preliminary evaluation is made and the treatment is performed by a specialist urologist before the surgical treatment decision is taken.
