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- Title
Clinical effect of computed guided pudendal nerve block for patients with premature ejaculation: a pilot study.
- Authors
Aoun, Fouad; Mjaess, Georges; Assaf, Joseph; Chemaly, Anthony Kallas; Younan, Tonine; Albisinni, Simone; Absil, Fabienne; Roumeguère, Thierry; Bollens, Renaud
- Abstract
Background: Premature ejaculation has a complex etiology, and its pathophysiology is still unclear, with penile hypersensitivity being the most accepted hypothesis. The aim was to investigate the efficacy and safety of a computed tomography-guided pudendal nerve block at the level of the sacrospinous ligament and the Alcock's canal in patients with premature ejaculation refractory to conventional pharmacological treatment. Methods: This is a prospective pilot study involving five patients suffering from premature ejaculation refractory to standard treatment and clinical features of pudendal nerve entrapment. A CT-guided infiltration of ropivacaine and methylprednisone was done at the levels of sacrospinous ligament and Alcock's canal. Intra-vaginal ejaculatory latency time (IELT) was recorded several times for each patient before and after infiltration. International Index of Erectile Function (IIEF-5), Premature Ejaculation Diagnostic Tool (PEDT) and Sexual Quality of Life–Male version (SQoL-M) questionnaire were also evaluated before and after infiltration. Results: Overall IELT differed significantly before and after treatment (21.94 vs 215.42 s; p = 0.039). IIEF-5, PEDT and SQoL-M also differed significantly before and after treatment. No complications for the CT-guided infiltration were recorded. Conclusion: CT-guided pudendal nerve block at the sacrospinous ligament and the Alcock's canal was effective in improving premature ejaculation. Therefore, pudendal nerve entrapment may be a curable cause of sensory premature ejaculation.
- Subjects
PUDENDAL nerve; PREMATURE ejaculation; NERVE block; PILOT projects; ETIOLOGY of diseases; LIGAMENTS
- Publication
Scandinavian Journal of Urology, 2020, Vol 54, Issue 3, p258
- ISSN
2168-1805
- Publication type
Article
- DOI
10.1080/21681805.2020.1770855