Patient's question:
Premature ejaculation has been treated before without improvement. It involves a circumcision and a surgery on the dorsal nerve of the penis.Doctor's answer:
Primary premature ejaculation and increased glans sensitivity are related to low ejaculation threshold and high central nervous system excitability. Glans sensitivity can be reduced and the ejaculation threshold can be raised by using topical anesthetics such as lidocaine cream or dibucaine ointment, or by engaging in intercourse with a condom. High central nervous system excitability can be managed with antidepressants such as sertraline, fluoxetine, or paroxetine. Combined with behavioral therapy for premature ejaculation, these methods can also help prolong ejaculation time, achieve satisfactory sexual life, such as intercourse with a condom, adjusting positions, multiple orgasms, scrotal traction, and penile massage.