Mp76-16 Reconstruction of the Dorsal Nerves Branches After Excessive Penile Neurotomy

You have accessJournal of UrologySexual Function/Dysfunction: Surgical Therapy II (MP76)1 May 2024MP76-16 RECONSTRUCTION OF THE DORSAL NERVES BRANCHES AFTER EXCESSIVE PENILE NEUROTOMY Nika Akhvlediani Nika AkhvledianiNika Akhvlediani View All Author Informationhttps://doi.org/10.1097/01.JU.0001009484.98400.42.16AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: In recent years, there has been an increase in the number of penile neurotomies performed in early ejaculation cases in countries where this procedure is not limited by clinical guidelines. Given the lack of standards for the surgical technique of this operation, in a number of situations, excessive loss of sensitivity of the penile glans may occur, which negatively affects erection. Previously, in such cases, the technique of penile reinnervation by transplantation of the sural nerve was described. The aim of our study was to evaluate the possibility of restoring sensitivity of the penile glans by autografting the branches of the dorsal nerves. METHODS: The prospective study included 36 patients aged 33.7±6.2 years with erectile dysfunction due to redundant penile neurotomy performed at other institutions. For surgical reinnervation of the penile glans, all patients underwent microsurgical grafting of large (≥2 mm) branches of the dorsal nerve bundle with the least extensive defect. Sections of dorsal nerve trunks with similar diameters and more significant diastasis were used as grafts. Before the grafting procedure and 6 months after the operation, biothesiometry of the penile glans was performed at a frequency of 64 Hz, as well as a questionnaire using the Sexual Health Inventory For Men (SHIM). RESULTS: Vibration sensitivity of the penile glans before surgical reinnervation of the penis and 6 months after it was 10.7±2.1 and 7.6±1.8 decibels, respectively (p=0.041). The results of the questionnaire on the SHIM scale within the specified period significantly increased from 11.2±2.4 to 18.6±3.3 points (p=0.035). CONCLUSIONS: The first experience with autografting of the dorsal nerve bundle indicates the possible effectiveness of this method of surgical reinnervation of the penile glans after excessive penile neurotomy. It is promising to continue studying the results of using this technique. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1248 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Nika Akhvlediani More articles by this author Expand All Advertisement PDF downloadLoading ...