How effective is selective dorsal neurectomy/cryoablation in treatment of premature ejaculation?

The use of selective dorsal neurectomy (SDN)/cryoablation (CA) as a treatment option for patients with premature ejaculation remains controversial, according to a study. SDN/CA affects intravaginal ejaculatory latency time (IELT) and patient satisfaction.

“Premature ejaculation is a prevalent sexual dysfunction with limited treatment options for some patients,” the authors said. "SDN/CA has emerged as a potential treatment, aiming to desensitize the penis.”

In this systematic review and meta-analysis, the authors identified randomized controlled trials, clinical trials, and prospective/retrospective studies using the databases of Embase, PubMed, Cochrane, and Web of Science. They assessed study quality using the Cochrane risk-of-bias tool and Risk of Bias in Nonrandomized Studies of Interventions-I tool.

Moreover, the authors evaluated IELT, questionnaires (Premature Ejaculation Diagnostic Tool, Premature Ejaculation Profile, Sexual Satisfaction Score), erectile status (International Index of Erectile Function-5), and adverse events. Finally, statistical analyses were conducted using a comprehensive meta-analysis and R software.

Seven studies including a total of 235 patients met the eligibility criteria. SDN/CA led to significant improvements in IELT (mean difference 147.47 sec; p<0.05), while questionnaires showed improvements in sexual satisfaction and ejaculation control.

However, erectile function did not significantly change. The rate of adverse events was 11.17 percent, with no significant between-group difference.

“The heterogeneity of the included studies and short-term follow-up periods shed light on further research,” the authors said. “However, further research into standard protocols and longer follow-ups is needed.”