[Don’t be embarrassed for a minute, sir! ]
How many premature ejaculation patients, because of this hit the floor slogan, lie on the operating table of the men’s hospital and receive an operation with inaccurate curative effect, imperfect technology and inappropriate clinical promotion-dorsal penis nerve block.
Is this what’s operation? Is there any harm to what?
The beginning of the story
I am an ordinary urologist. Although my skills are mediocre, I insist on the minimum medical ethics.
A few years ago, on the 4th of the first month, I received a phone call from my friends, asking me to go to a men’s hospital to do an indirect hernia repair. When three times five divided by two finished the indirect hernia repair and sewing skin, I heard the touring nurse quietly calling: it’s your turn to take the stage.
I was startled and still had to use a knife on the patient? The itinerant nurse’s expression was extremely unnatural, and she confided her true feelings under questioning. The following circumcision + dorsal penis nerve amputation did not need to bother me.
I stubbornly refused to go.
Two male doctors in their 30s came on stage, Perhaps my eyes shocked them. They did circumcision with trepidation. At least finished, and then in the penis root made a transverse incision, in turn incision skin, fascia and other tissues, there churning out the dorsal nerve of the penis. I have not done this operation, by the way to learn, theoretically will soon dissect the dorsal nerve of the penis, cut off several dorsal nerve branches into the penis head, the operation is OK.
The operation field of vision was bloody and gave me a headache. At this time, the supervisor forced me out of the operating room.
I suspect they didn’t do anything. They usually cut the root of the penis, or did it at random, then sewed up the wound, and then declared to the patient that the operation was very successful and smooth.
I didn’t go to the supervisor’s office to receive my remuneration. A strong feeling of aiding and abetting the abuse invaded my whole body. I hope the evil I see in front of me is a movie plot that can be abridged and forgotten.
How is premature ejaculation?
At present, the most commonly used definitions are those of the American Psychiatric Association and the World Health Organization.
The American Psychiatric Association defines premature ejaculation as:
Persistent or periodic minimum stimuli are ejaculated before, at or shortly after insertion and before one wishes, causing significant pain or affecting the partnership.
The World Health Organization defines premature ejaculation as:
Inability to delay ejaculation under full enjoyment of sex is manifested as one of the following:
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Ejaculate soon before or after sexual intercourse (within 15 seconds);
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Ejaculation occurs before full erection reaches the possibility of sexual intercourse. The difficulty is not caused by long-term lack of sexual life.
Is this a what operation?
Dorsal penile nerve block, as its name implies, is to cut off some nerves located in the penis by surgery.
Excessive sensitivity of penis sensation and high excitability of penis sensory nerve are the causes of premature ejaculation.
Based on this theory, part of the sensory nerve is cut off by surgery, which causes the sensitivity of penis head to decrease and the afferent nerve impulse to decrease, thus prolonging the time for ejaculatory nerve to reach the excitation threshold, thus possibly achieving the purpose of treating premature ejaculation.
In 1993, Tullii et al. Reported the treatment of dorsal penile nerve occlusion.
In China, Zhang Chunying, a professor of andrology in the Second Affiliated Hospital of Harbin Medical University, took the lead in carrying out this operation in September 2001. Subsequently, this operation has mushroomed all over the country, but it is mostly limited to private andrology hospitals.
How was the operation?
The efficacy and safety of the operation have not been recognized by the industry.
The research results of this operation at home and abroad are totally different. The limited domestic literature claims to have an effective rate of up to 90%, while the effective rate of foreign literature is less than 50%, and there are many complications. Domestic academics are good at cheating, you know.
Even as a scientific research operation, the operation has the strictest indications in the university affiliated hospitals with the best conditions in China. The operation patients must meet the following conditions at the same time:
Erectile function is normal;
Married or with fixed sexual partners and regular sexual life for more than 1 year;
Severe premature ejaculation;
No other organic factors;
Normal psychological quality;
It is effective to smear local anesthetic on penis.
Conventional sexual therapy is still ineffective for more than 2 months.
The age is generally < 40 years old, or > 40 years old but has a strong desire for surgery.
After summarizing the clinical data of university affiliated hospitals in Harbin, Beijing, Shanghai and other megacities, the conclusion is:
The curative effect of dorsal penile nerve occlusion is very uncertain, and the technology itself is not perfect. At most, it can be used as scientific research discussion after fully considering the wishes of patients and absolutely cannot be used for clinical promotion.
The danger of surgery?
General complications
Risks of infection, hemorrhage, incision dehiscence, etc.;
Severe complication
Penile numbness and erectile dysfunction (ED);
If too many branches of dorsal penile nerve are cut off, some more serious complications will easily occur in dorsal penile nerve occlusion.
The International Medical Association clearly pointed out in the latest < < 2014 Guidelines for Diagnosis and Treatment of Premature Ejaculation > > that:
Resection of dorsal penis nerve may lead to permanent loss of sexual function and is not recommended for premature ejaculation treatment.
Under normal circumstances, cutting off some branches of dorsal penile nerve does not affect erectile function, but it may cause numbness of penis and obvious lack of sensation, which will reduce the function of penile reflex erection and affect penile erectile function.
Elderly men themselves are prone to ED, and this operation must not be used for the elderly or premature ejaculation patients complicated with ED.
Status Quo: Reduced to a Tool for Money Collection
All urological textbooks do not mention dorsal penis nerve occlusion.
However, this operation, which is almost denied in the industry, is widely used by private men’s hospitals and has become one of the main means of collecting money in private men’s hospitals. Patients with serious complications such as penile numbness and erectile dysfunction (ED) after operation are everywhere.
For patients with premature ejaculation, please take good care of your cock and firmly say to the men’s hospital, which uses this as a gimmick to solicit patients and takes dorsal penis nerve blocking as the first choice for treatment: I will not do this operation, I will never do it! For patients with premature ejaculation, please go to a regular hospital.
Responsible Editor: Cat Capricorn