What is Selective Dorsal Cryoablation?
Selective dorsal cryoablation is an innovative microsurgical technique used in the treatment of primary (lifelong) premature ejaculation, aimed at reducing hypersensitivity of the penis. In this procedure, specific branches of the dorsal nerve are targeted and selectively blocked using freezing (cryotherapy) technology. The goal is to optimize hypersensitivity without affecting erection quality.
Preoperative Preparation Process
Before deciding on surgical intervention, a detailed urological examination of the patient is performed. Biothesiometry (sensitivity testing) is utilized to confirm that the premature ejaculation is due to penile hypersensitivity rather than psychogenic or hormonal factors. Routine pre-operative blood tests are completed, and the patient's suitability for the procedure is evaluated.
How is Selective Dorsal Cryoablation Performed? Step-by-Step
The operation is performed under sterile operating room conditions, using local anesthesia, sedation, or general anesthesia. The surgical steps are as follows:
- Anesthesia Administration: The appropriate anesthesia method is selected to ensure patient comfort.
- Micro-incision and Access: A minimal incision is made through the circumcision line or just below the penis to access the dorsal nerve anatomy.
- Nerve Mapping: Under a high-resolution surgical microscope, the dorsal nerve fibers providing sensation to the penis are individually isolated.
- Cryoablation (Freezing): A special cryoprobe is placed on the targeted specific nerve branches. Cold temperatures ranging from -40 to -60 degrees Celsius are applied to selectively interrupt nerve conduction.
- Closure and Dressing: After the nerve blockade is completed, the incision site is closed with aesthetic sutures and a sterile dressing is applied.
Recovery Process and Postoperative Care
Selective dorsal cryoablation is an outpatient procedure that typically does not require hospitalization, allowing patients to be discharged on the same day. During the recovery period, the following points should be considered:
- Mild swelling and bruising are normal for the first few days; cold compresses may be recommended.
- Sexual intercourse should be avoided until complete healing is achieved (usually 4-6 weeks).
- Strenuous physical activities and heavy exercise should be avoided for the first 2 weeks.
- Antibiotics and pain relievers prescribed by the physician must be used regularly.
What are the Advantages of This Method?
Compared to traditional neurectomy (nerve cutting) methods, the cryoablation procedure offers significant advantages. Since the nerve fibers are not completely severed, the risk of permanent sensory loss or neuropathic pain is minimized. Furthermore, it does not carry a risk of erectile dysfunction and features a reversible mechanism of action.