Selective dorsal cryoneurolysis a promising intervention for premature ejaculation

Men with refractory lifelong premature ejaculation (PE) may benefit from selective dorsal cryoneurolysis, a minimally invasive, potentially reversible neuromodulatory intervention that has been shown to be safe and effective in a recent study.

Some 108 men with lifelong PE (mean age 40.4 years, BMI 25.5 kg/m²) who underwent selective dorsal cryoneurolysis (SDC) between January 2024 and January 2025 were included in the analysis. Participants reported intravaginal ejaculatory latency time (IELT) <1 min, normal erectile function, and inadequate response to pharmacological and behavioural treatment.

The investigators examined IELT, Premature Ejaculation Diagnostic Tool (PEDT), Premature Ejaculation Profile (PEP), penile vibration-perception thresholds (biothesiometry), adverse events, and treatment failure to 12 months. They also tested normality with Shapiro‒Wilk and analysed changes over time with Wilcoxon signed-rank and paired t-tests and the Friedman test.

At 12 months, geometric-mean IELT rose to 231.1 s (95 percent confidence interval [CI], 209.1‒256.0) from 54.4 s (95 percent CI, 45.8‒64.5), with a nearly fourfold improvement reached by month 3 and sustained thereafter (p<0.001).

PEDT score decreased from 14.3 to 8.4, while the total PEP score increased from 6.0 to 11.6 (p<0.001 for both), suggesting improvements in premature ejaculation. Penile thresholds increased from ~4.5 to ~10.7 V at all sites (p<0.001), indicating objective desensitization.

Eight men (7.4 percent) experienced procedure-related discomfort, all mild and self-limiting, and 11 participants (10.2 percent) reported persistent PE. Eighty-two men (75.9 percent) underwent a second session and 22 (20.4 percent) a third session. Erectile dysfunction, anorgasmia, persistent numbness, or infection did not occur.

“Selective dorsal cryoneurolysis … remains investigational, and prospective randomized controlled trials are warranted to confirm long-term durability and comparative efficacy,” the investigators said.