SURGERY FOR PREMATURE EJACULATION

Premature ejaculation is the difficulty in controlling ejaculation very soon after penetration. It is completely normal for premature ejaculation to occur occasionally, but when it happens frequently or in most encounters, it is when it is considered a problem.

Premature ejaculation is very common and approximately 20-30% of men suffer from it. For the treatment of premature ejaculation, several types of treatments can be performed:

SURGERY (Selective Neurotomy of Penis):

This is an outpatient surgery, in which an incision is made around the penis as is done in circumcision. Then, the penile nerves are located and only the excess of these are cut, seeking to reduce the exaggerated sensitivity of the patient’s penis. After surgery, the patient continues to have sensitivity in the penis like any normal person in order to have a pleasurable sexual intercourse.

After surgery, there may be some swelling of the penis. The patient should have 3-5 days of rest at home.

To resume physical exercise, you should wait 3-4 weeks and to resume sexual activity, you should wait 6 weeks in total.

Surgery is not effective in 100% of cases. Approximately 33% are completely cured, 33% have significant improvement and 33% have mild or no improvement. It is important to emphasize that surgery should be the last treatment option, once all other options have been exhausted.

Dr. Wadskier’s father (also a urologist) is one of the developers of this surgery and was Dr. Wadskier’s mentor for this technique. There are very few urologists trained to perform this type of surgery.

HYALURONIC ACID INJECTION IN GLANS PENIS

This is an office procedure, under local anesthesia, in which 2-3 cc of hyaluronic acid is injected into the glans penis (which is the most sensitive area of the penis). decreasing sensitivity. It has very good results but like premature ejaculation surgery, it should only be considered in cases where there is no good response to medical treatment.

Training to perform this procedure is carried out in conjunction with the exclusive Urofill group.

NON-SURGICAL TREATMENTS:

• Use of serotonin reuptake inhibitors (antidepressants): they are used not for their effect as antidepressants but for their side effect, which is to prolong the time to ejaculation.
• Phosphodiesterase 5 inhibitors: these are drugs used to improve erection (Viagra, Cialis, etc.). In some patients with erectile dysfunction, improving the quality of erection indirectly improves the time to ejaculation.
• Use of topical anesthetics: used to decrease penile sensitivity.
• Use of condoms with retardant: they contain topical anesthetics that decrease penile sensitivity.

TECHNIQUES TO IMPROVE TIME TO EJACULATION:

Foreplay: many men forget the importance of foreplay before penetration. Prolonged foreplay can improve partner satisfaction, may achieve orgasm
of the partner prior to penetration and can indirectly improve self-confidence and achieve an increase in time to ejaculation.

Start with the partner on top or on the side: there are positions that produce more stimulation and therefore are not recommended for the initiation of intercourse in patients suffering from premature ejaculation. The recommendation is to start with the partner on top or on the side, and once you are lingering long enough, you can switch to any other position of your preference.

Stop & Squeeze: consists of
to pull out the penis when you feel the imminent desire to ejaculate and apply pressure just below the glans for about 5 to 10 seconds. Once the desire to ejaculate decreases, intercourse can be resumed.
The suggestion is to do this up to 3 times in each relationship.