Microsurgical selective penile dorsal neurotomy is an advanced surgical treatment method that provides a permanent solution for premature ejaculation. The aim of this procedure is to permanently reduce penile hypersensitivity and make the ejaculation reflex more controllable. Performed under a microscope, the operation is based on selectively reducing the activity of the nerves located on the sides and dorsal part of the penis. In this way, ejaculation time is prolonged while the natural sensation and erectile function of the penis are fully preserved.
When Is Microsurgical Selective Penile Dorsal Neurotomy Performed?
- It is applied especially to patients who experience severe premature ejaculation due to excessive sensitivity in the glans (penis head) and penile shaft.
- It is an excellent option for patients who have tried temporary treatments (such as medications, creams, neuroablation, or penile glans fillers) but now seek a permanent solution.
How Is Microsurgical Selective Penile Dorsal Neurotomy Performed?
- The procedure is performed on an outpatient basis under spinal anesthesia, which provides temporary numbness below the waist during the operation.
- A small incision (approximately 1–1.5 cm) is made at the base of the penis, where the penile skin ends and pubic hair begins.
- Using a surgical microscope that provides enhanced visualization, all sensory nerve fibers located at the root and sides of the penis are identified. The thicker nerve fibers are cut and reconnected, while the thinner ones are cut and left sealed at both ends. This allows the penile sensory nerves responsible for the ejaculation reflex to be selectively and permanently modified.
- The operation takes about one hour and is performed entirely under a microscope (microsurgically).
- After the procedure, the incision is closed aesthetically and covered with a small dressing.
- Patients can go home the same day after a few hours of rest. Usually, they can resume daily activities and work the following day.
Advantages of Microsurgical Selective Penile Dorsal Neurotomy
- Provides a permanent result, as the ejaculation reflex is brought under long-term control.
- Reduces penile sensitivity while preserving natural sensation.
- Erectile function remains unaffected, since only sensory nerve fibers are modified.
- Nerves are visualized selectively under a microscope, ensuring no damage to surrounding tissues.
- As a same-day surgical procedure, patients can return home immediately and quickly resume normal life.
- Leaves minimal visible scarring, offering a natural aesthetic result.
Postoperative Recovery Process
- Resumption of sexual activity is recommended after approximately 3–4 weeks.
- During the first intercourse, patients can clearly notice reduced penile sensitivity, longer intravaginal duration, and improved control over ejaculation.
Final Notes
Microsurgical selective penile dorsal neurotomy is a personalized, mini-surgical technique that provides a permanent and scientifically proven solution to premature ejaculation.
This one-hour, outpatient procedure performed under spinal anesthesia helps patients enhance the quality of their sexual life and regain psychological confidence.
