Patient's question:
From the first time until now, it has been over a minute. Currently, I am driving. I have the habit of masturbation, and stimulating the penis with my hand can lead to ejaculation in just two or three minutes. Wearing a condom doesn't help, and neither does distracting myself—I can't control it. Please guide me, skilled doctors. I'm only 25 now, and I'm really starting to feel overwhelmed by this pressure.Doctor's answer:
Hello, for patients with primary premature ejaculation, the glans penis is much more sensitive than that of normal individuals, and the excitability of the sensory nerves is higher. The latency period of ejaculation and the reflex arc of ejaculation are shorter, and the threshold for ejaculation is lower, making it easier to induce premature ejaculation during sexual activity. So, how is primary premature ejaculation treated? There are several methods for treating primary premature ejaculation, such as massaging before bedtime, pressing acupoints like Guanyuan, Qihai, and Zhongji with the hands every night before sleep. Methods like pressing the perineum and traction also have certain therapeutic effects, and the treatment is more effective with the cooperation of the female partner. However, some experts believe that the female partner's cooperation may exacerbate primary premature ejaculation. Currently, the medical community has not reached a conclusion.The latest surgical method for treating primary premature ejaculation is called the distal partial resection of the penile dorsal nerve. Despite the long name, the surgery is actually quite simple. Previously, treatment methods for premature ejaculation often used sensate focus training, which required long-term cooperation from the partner and had uncertain efficacy, making it difficult to complete the treatment cycle. Oral antidepressants for treating premature ejaculation have an efficacy rate of about 50% but have significant side effects. Local medication dosages are hard to control, often leading to sexual or erectile dysfunction. Penile implant surgery is expensive. Therefore, there is currently no very effective method for treating primary premature ejaculation.
This surgical technique is performed under local anesthesia, making a 1 cm to 2 cm horizontal incision on the coronal sulcus of the penile back skin, the fascia to expose the radially distributed penile dorsal nerves. Except for the central nerve branches, the number of distal nerve roots to be resected is determined based on the distribution of the penile nerves to partially reduce their sensitivity. The incision is then sutured, and recovery typically occurs within 1 week, with sexual activity possible after 20 days. Currently, the sexual activity time of patients before surgery is all less than 1 minute. Post-surgery observations show the shortest sexual activity time is 6 minutes, the longest is 30 minutes, and the average is 16 minutes.