Premature ejaculation (ejaculation) - symptoms and treatment

One of the forms of primary premature ejaculation is the so—called paracentral lobule syndrome. With this congenital disease, the causes of which remain unclear, a typical manifestation, along with premature ejaculation, is bedwetting (enuresis).The secondary (acquired) form of premature ejaculation occurs due to a number of diseases, such as hypogonadism (decreased testosterone levels), chronic prostatitis, etc. Excessive thyroid function (hyperthyroidism) may also have a certain value. This form of premature ejaculation is often combined with erectile dysfunction, exacerbating existing sexual disorders.
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The treatment of premature ejaculation should be handled by an andrologist specialist who is well acquainted with this problem. Various forms of this disease and the abundance of its causes require careful examination. Only an accurate diagnosis is the key to successful and effective treatment. One or another method of treating premature ejaculation is prescribed by the doctor individually, based on the established form (primary or secondary), the characteristics of the patient (presence or absence of a permanent sexual partner, regular or promiscuous sexual life) and his preferences (adherence to conservative / drug treatment or, conversely, the desire to radically solve the existing problem surgically). The patient's age also matters.To assess the duration of sexual intercourse, the degree of satisfaction and erectile function, a variety of tests and questionnaires are used. The functional state of the brain is assessed using electroencephalography (EEG). In secondary forms of PE, it is necessary to study the hormonal status (sex and thyroid hormones). To exclude chronic prostatitis, it is advisable to examine the secret of the prostate (including microbiological analysis), ultrasound examination of the prostate gland and seminal vesicles. PCR diagnostics of urethral scraping helps to identify "hidden" infections. In some cases, an endoscopic examination — urethroscopy - may also be prescribed.
Treatment of secondary forms of premature ejaculation, which are a manifestation or consequence of another disease, is designed to eliminate the cause that caused it. So, with chronic prostatitis, improvement is achieved by normalizing the state of the prostate gland, stopping the inflammatory process. Hypogonadism requires the appointment of testosterone drugs. And hyperthyroidism is a reason to turn to an endocrinologist to restore normal thyroid function.
Penile neurotomy surgery can be performed under local or general anesthesia. A layer-by-layer dissection of the skin and tissues to the protein membrane of the penis is performed. Further, using optical magnification and microsurgical instruments, the branches of the dorsal nerves of the penis are isolated and intersected, providing sensitivity of the head. The intersection can be performed at the level of the base of the penis, where the dorsal nerves are represented by rather large trunks, or closer to the head, where the trunks are divided into smaller branches. Each of these techniques has its pros and cons. Thus, with the complete intersection of the main trunks of the dorsal nerves, it is possible to develop complete anesthesia of the glans penis, which negatively affects both sensations during sexual intercourse and erection. The latter may disappear right during sexual intercourse due to lack of sexual stimulation. The operation ends with suturing the wound and applying a bandage with a slight degree of compression to avoid the formation of hematomas. The rehabilitation period after the performed denervation of the head is on average 10 days. Sexual recovery is usually possible three weeks after surgery. This operation is highly effective and has a low relapse rate. She has more and more adherents among practicing urologists-andrologists source of information.