Exhibition Hall (Room 517-AB) | Male - Sexual Dysfunction Time: - |
The afferent interrupted way for Premature Ejaculation Treatment.
Diaz, Augusto*,1, Eguez , Fernando2, 1 Augusto Díaz, Quito, Pichincha, Ecuador2
ABSTRACT- Introduccion.-Premature ejaculation may be classified in secondary or acquired and primary or lifelong.For secondary PE. a specific ethiological treatment is employed.For lifelong PE.several treatments have been utilized:SSRI,PDE5,topical anesthesia and associated with psychogenic drugs.None of these treatments have received regulatory approval for true PE. treatment. At present we are suggesting a new treatment for interrupting nervous afferent reflex arc. Ejaculation is a reflex that comprises:sensory receptors,afferent nervous pathways,cerebral sensory centers,cerebral motors centers,spinal motors centers and efferent pathways nervous. The ejaculation reflex is controlled by a very complex mechanism between neurotransmiters,which depolarize perineal muscles,deferents, seminal vesicles,prostate and urethra muscles,begin rhythmic contractions and seminal emission. Material and Methods.-Men with PE. have abnormal autonomic reflex pathways for ejaculatory event,because they have an abnormal status called hypersensitivity.This can be proved by several neurophysiological tests, vibratory threshold ejaculation test,skin sensitivity test. If we interrupt the reflex way,we can delay the reflex response,we can length the response time,we can decrease existent hypersensitivity and we can extend the ejaculatory latency time. Supported in this concept and true fact,we perform selective neurotomy to treat PE. Since 15 years ago,we have studied and have proved that men with PE.have Hypersensitivity and superficial nervous hyperplasia. Our work was divided in:a-Anatomical studies for normal sensitive penis nervous distribution,in 40 corpses of young people died by accident b-Clinical studies(tests). c- Medical sexual,psychological history and physical examination. We perform a Selective Neurotomy to verify:Surgically: sensitive nervous hyperplasia and interuption of sensitive afferent nervous. Clinically: symtomatic improvement and permanently cure and a very big neurophysiological tests change. Results.-We have performed 276 plain selective neurotomy,36 selective neurotomy plus venous ligature,42 selective neurotomy plus Nesbit procedure.Which arise a grand total of 354 surgical procedures. The results were very satisfactory,changing from 3 to 24 minutes IELT.,except in 8,which nervous hyperplasia was recently confirmed.(see tables) Conclusions:1.-Good results depend from a good diagnosis 2.-Now for us,this is the best treatment for PE. 3.-Sometimes psychological support is requiered. 4.-Finally,I am sure this is the first paper about this kind of PE. treatment,that is presented in the world.
Key words: Afferent interrupted way, Reflex arc, Hypersensitivity, Sensitive nervous hyperplasia, Plain selective neurotimy