OBJECTIVETo investigate the number, course and distribution of normal dorsal penile nerves and their clinical significance for selective neurectomy of the dorsal penile nerve in the treatment of primary premature ejaculation.

METHODSWe dissected 38 cadaveric adult penises and recorded the number, course and distribution of the dorsal penile nerves. A total of 314 cases of primary premature ejaculation underwent selective neurectomy of the dorsal penile nerve. The patients ranged between 20 and 45 years in age and from 1 to 22 years in disease course.

RESULTSThe dorsal penile nerves were distributed in parallel bilaterally in all the cadaveric penises and branched into the ventral side in 4 of them. The total number of dorsal penile nerves was (3.6 +/- 1.2) in the 38 cadaveric penises, 7 in 1 case, 6 in 1 case, 5 in 6 cases, 4 in 9 cases, 3 in 14 cases and 2 in 7 cases, while that of the 314 patients with primary premature ejaculation was (7.0 +/- 1.9), 5 in 64 cases, 6 in 56 cases, 7 in 52 cases, 8 in 40 cases, 9 in 33 cases, 10 in 28 cases, 11 in 25 cases, 12 in 11 cases and 13 in 5 cases. Selective neurectomy of the dorsal penile nerve achieved an intravaginal ejaculation latency of (4.31 +/- 1.87) minutes and sexual satisfaction rate of (61 +/- 17) %, significantly different from those before the operation ([1.24 +/- 0.32] min, [23 +/- 6] %; all P < 0.01).

CONCLUSIONThe abnormal increase of dorsal penile nerves possibly lies at the bottom of the pathogenesis of primary premature ejaculation. Selective neurectomy of the dorsal penile nerve is safe and effective for the treatment of primary premature ejaculation.