Radiofrequency pulse modulation of the penile dorsal nerve for the treatment of premature ejaculation: evaluation of effectiveness

Abstract

Introduction.  Premature ejaculation (PE) is the second most common male sexual dysfunction with a significant negative impact on quality of life. A significant number of conservative and surgical methods for the treatment of PE are proposed, but their effectiveness and, in some cases, safety, remain the subject of discussion.Objective. To study the effectiveness of pulsed radiofrequency impulse neuromodulation (RPN) with different modes on the penile dorsal nerve in treatment of patients with premature ejaculation.Materials & methods. Two groups of PE-patients participated in a prospective multicenter study: Group 1 — 11 patients aged 22 – 34 years; Group 2 — 12 patients aged 23 – 34 years. Group 1 received pulsed RPN at a temperature of 42°C, a stimulation frequency of 2 Hz, 45 V, and a duration of 180 seconds; in Group 2 — pulsed RPN at a temperature of 50 °C and the same frequency and duration of stimulation as Group 1. All patients before and after treatment measured intravaginal ejaculation latency time (IELT) and completed a premature ejaculation profile (PEP). The results were evaluated after 30 days.Results. In both groups, there was a statistically significant increase in IEDT and PEP. Thus, in Group 1, IELT increased from 58 to 101.9 seconds, PEP from 3.8 to 12.6 points. In Group 2, IELT increased from 66.5 to 210.9 seconds, PEP from 3.2 to 12.6 points. At the same time, in Group 2, IELT increased by 107% more than in Group 1. No significant side effects were observed in both groups.Conclusion. RPN appears to be a very promising treatment for premature ejaculation, as it is a minimally invasive, safe, and reversible procedure. The technique of influencing the penile dorsal nerve at an electrode temperature of 50 °C compared to 42 °C seems to be more effective, however, additional studies are needed.