Neurectomy (SDN) Surgery for Premature Ejaculation

Neurectomy (SDN) Surgery for Premature Ejaculation

Premature ejaculation is the condition in which a man cannot maintain control during intercourse and ejaculates involuntarily shortly after arousal. Most men try to cope with this problem for years using temporary methods such as delaying sprays, creams or psychotropic tablets. However, these methods work only while they are being used, and the problem returns as soon as they are stopped.

If the premature ejaculation is caused by anatomical hypersensitivity (hyperaesthesia) of the glans penis, the lasting solution is Selective Dorsal Neurectomy (SDN), that is, neurectomy surgery for premature ejaculation. Below we set out this surgical approach in detail, as performed by Op. Dr. Taylan Yanar at our Andrology Clinic in Mavisehir, Izmir.

The Rationale Behind Neurectomy Surgery for Premature Ejaculation

In a significant proportion of patients with premature ejaculation, the number of sensory nerves in the glans penis is higher than normal, or the stimulation threshold is very low. From the moment sexual contact begins, an excessive volume of signals reaches the ejaculation centre of the brain within seconds and the man ejaculates involuntarily.

Selective Dorsal Neurectomy (SDN) is the selective division, under a high-magnification operating microscope, of the excess nerve fibres responsible for the hypersensitivity of the glans.

• A selective approach: the aim of the operation is not to eliminate sensation in the glans entirely. The aim is to bring excessive stimulation down to the standard level of a healthy man.
• Lasting balance: because the divided excess nerve branches are not replaced, the control that is gained is permanent for life.

How Does the Operation Proceed?

Preliminary assessment: the patient's anatomy and the sensitivity of the glans are confirmed by clinical examination.

The operation: it is performed under local anaesthesia or light sedation. Access is gained through a 1 to 2 cm micro-aesthetic incision made just above the circumcision line.

Selective division: between 30 and 50 per cent of the superficial nerve branches responsible for excessive stimulation are carefully divided. The main nerve trunk is left untouched.

Duration and recovery: the procedure takes 45 to 60 minutes on average. The patient can return home the same day. Approximately four weeks of sexual abstinence is required for tissue healing.

Frequently Asked Questions

Does neurectomy surgery for premature ejaculation affect erection?

Certainly not. The vessels and deep nerve bundles that provide erection lie within the internal structure of the penis. SDN surgery is performed on the superficial sensory nerve endings just beneath the skin, and has no adverse effect on erection.

Is there a complete loss of sensation after the operation?

No. Because the main nerve trunk is preserved, the sense of touch and sexual pleasure continue exactly as before; only the excessive sensitivity is balanced, so intercourse lasts longer.