http://orcid.org/0000-0002-8703-4611
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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.
Author contributions
Conceptualization: F. Aoun, F. Absil and R. Bollens. Methodology: F. Aoun, F. Absil and R. Bollens. Formal analysis: F. Aoun, G. Mjaess and J. Assaf. Investigation: F. Aoun, A. K. Chemaly, T. Younane, and R. Bollens. Writing – Original draft: F. Aoun and G. Mjaess. Writing – Review and editing: F. Aoun, G. Mjaess, J. Assaf, A. K. Chemaly, S. Albisinni and T. Roumeguère.
Disclosure statement
No potential conflict of interest was reported by the author(s).