(118) Clinical Outcomes of Selective Dorsal Cryoneurolysis in Patients with Lifelong Premature Ejaculation: A Retrospective Cohort of 108 Men

Introduction Premature ejaculation (PE) remains the most prevalent male sexual dysfunction, and available medical therapies often provide temporary benefit. Selective dorsal cryoneurolysis (SDC) is a novel minimally invasive neuromodulatory procedure designed to increase penile sensory threshold and improve ejaculatory control without compromising erectile or tactile function. Objective To evaluate the clinical efficacy and safety of SDC in patients with lifelong PE, focusing on changes in intravaginal ejaculatory latency time (IELT) and Premature Ejaculation Diagnostic Tool (PEDT) scores. Methods Medical records of 108 men with lifelong PE treated with SDC between 2024 and 2025 were retrospectively reviewed. Inclusion criteria were IELT < 1 minutes, PEDT ≥ 11, and failure of pharmacological or behavioral therapy. Procedures were performed under local anesthesia using a 3 mm cryoprobe, applying targeted ablation at the dorsal midline zones identified by intraoperative mapping. Demographic data and pre- and post-operative measurements were analyzed. IELT, sensory thresholds (SENS; base, frenulum, right and left glans), and PEDT scores were assessed at baseline and at 1, 3, 6, 9, and 12 months post-procedure. Normality was tested with the Shapiro–Wilk test; longitudinal changes with paired or Wilcoxon tests; and repeated-measures comparisons with the Friedman test. Correlations between ΔIELT and ΔSENS values were examined using Spearman's rank correlation. Results The mean IELT increased from 1.3 ± 0.4 min at baseline to 4.8 ± 1.4 min at 12 months (p < 0.001). The largest improvement occurred within the first 6 months, stabilizing thereafter. PEDT scores improved from 17.8 ± 3.2 pre-operatively to 12.2 ± 2.5 at 12 months (p < 0.001), consistent with a shift from severe to mild symptom severity. SENS measurements revealed the greatest rise in threshold at the frenulum (p < 0.001) and base (p < 0.01), confirming selective desensitization. ΔIELT correlated negatively with ΔSENS at the frenulum (r = –0.45, p = 0.02) and base (r = –0.30, p = 0.05), demonstrating that greater sensory modulation was associated with more pronounced IELT prolongation. No patient reported de novo erectile dysfunction, glans hypoesthesia, or other procedure-related complications. Conclusions SDC provides a safe, durable, and clinically meaningful improvement in ejaculatory control and patient satisfaction. These findings support SDC as a promising procedural option for men with lifelong PE refractory to conventional medical therapy. Disclosure No