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Unveiling the Connection: Can Varicocele Treatment Provide a Cure for Premature Ejaculation?

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Last Updated on May 26, 2023 by Max

Introduction

Premature ejaculation is a topic that many struggle with, but few are willing to discuss. As we navigate this sensitive subject, let’s delve into a potentially lesser-known factor associated with premature ejaculation – varicocele. Could treating varicocele pave the way for curing premature ejaculation? We will draw upon modern scientific data to explore this intriguing question and consider the implications for men worldwide.

The Correlation Between Varicocele and Premature Ejaculation

Several medical conditions, such as low testosterone, premature ejaculation, and erectile dysfunction, have been linked to varicocele. However, other factors such as overactive thyroid, prostatitis, genetic predispositions, poor overall health status, obesity, and erectile dysfunction can also contribute to premature ejaculation. It is a common misconception that only certain demographics are prone to premature ejaculation, but in reality, it affects men across various ethnicities and educational levels.

Our previous discussions have illuminated the organic link between varicocele, hypogonadism, and infertility. We identified that venous stasis in the internal spermatic vein could result in an intratesticular temperature increase, hypoxia, and accumulation of reactive oxygen species in the testicles. These developments, in turn, can contribute to the degeneration of spermatogenesis, decreased sperm quality, and quantity, and reduced testosterone production.

The Prevalence of Premature Ejaculation

Have you ever wondered about the scale of premature ejaculation in our society? H. Porst et al. 2007 surveyed 12,133 men across the United States, Germany, and Italy. Their results found the prevalence of premature ejaculation strikingly similar across these countries and age groups, debunking the myth that it’s only an issue among younger men.

Despite the widespread nature of this condition, the study found that a mere 9% of the men discussed it with their physician. Furthermore, most of these men were not satisfied with the outcomes of their treatments, indicating a deficiency in effective medical solutions for premature ejaculation.

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Available Treatment Strategies for Premature Ejaculation

According to the guidelines provided by the European Association of Urology (2016), the treatment approach for premature ejaculation varies based on the discomfort it causes and any concurrent conditions such as erectile dysfunction or prostatitis. The typical ejaculatory latency for men ranges between 4–8 minutes, with premature ejaculation being diagnosed when this duration is equal to or less than one minute.

Various psychological and pharmacological strategies are available for managing this condition. It’s essential to consider each method’s effectiveness and potential side effects. For instance, Dapoxetine, the only pharmacologically approved treatment for premature ejaculation in many countries (excluding the USA), has been proven to triple stimulation time from a baseline average of less than half a minute. However, it may also cause side effects like erectile dysfunction, diminished libido, and anorgasmia.

In contrast, surgeries like selective dorsal neurectomy and penis head growth using a hyaluronan gel injection promise lasting solutions.

Two surgeries allowing to get rid of premature ejaculation forever come from South Korea: selective dorsal neurectomy and penis head growth using a hyaluronan gel injection. Nevertheless, the International Society of Sexual Medicine has endorsed none of these approaches, yet, about 75% of Korean urologists recon them as safe and efficient treatments.

Kwak TI et al. (2008) performed penis head growth on 38 patients suffering premature ejaculation and followed up for five years for possible side effects. Compared to starting values, the latency time increased from 84.2 s. till 378 s. at six months and 352 s. in five years after treatment. There was no significant difference in the patient’s and the partner’s satisfaction between 6 months and five years.

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In another study, Zhang GX et al. (2012) made selective removal of dorsal penis nerves for 40 men with premature ejaculation and increased latency time from 1.1 to 3.8 min.  The authors concluded that the surgery is efficient in prolonging and controlling ejaculation, whereas erectile function is not affected.

And finally, some topical anesthetic agents like lidocaine cream showed an increase in latency time from one minute in the placebo group to 6.7 minutes in the treatment group. However, topicals are sometimes avoided due to the loss of sensation in the penis and for the partner.

However, the International Society of Sexual Medicine has not endorsed these treatments, highlighting the need for caution and consultation with a healthcare professional before proceeding.

It was only a glance at the main treatment approaches for premature ejaculation, without considering their pros and cons and side effects, to outline an overall picture of the problem and to move on to our topic, “Can we cure premature ejaculation by varicocele treatment.” 

Can Varicocele Treatment Cure Premature Ejaculation?

Several studies have found a higher incidence of premature ejaculation in men with varicocele. A compelling survey by Ahmed, A.-F, et al. (2015) demonstrated a significant correlation between varicocele and premature ejaculation. The study reported that varicocelectomy, a surgical procedure to treat varicocele, led to substantial improvements in premature ejaculation, erectile function, and testosterone levels.

In this study, 73 patients with varicocele suffering from premature ejaculation were undergone surgical varicocelectomy while the other group of patients (56 men) with the same diagnoses refused surgical intervention. As an outcome of this study, significant improvement in premature ejaculation was achieved:

  1. In the first group, 41.1% of patients showed improvement in premature ejaculation compared to 5.3% in the control group.
  2. Testosterone content and International Index of Erectile Function values in group 1 but not in group 2 also improved compared to pre-operative values.
  3. The size of the testicles increased after varicocelectomy but decreased notably in the second group.
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A significant improvement in premature ejaculation, erectile function, and testosterone level was observed in varicocele patients after varicocelectomy. And what is important, no varicocele recurrence or severe postoperative complications were noted until the end of the study; the follow-up period lasted six months.

Conclusion

The findings suggest a strong connection between varicocele, premature ejaculation, and testicular hormonal function. The positive outcomes observed post-varicocelectomy indicate promising potential for curing premature ejaculation. Therefore, if you find yourself grappling with premature ejaculation, it might be beneficial to have your testicles examined for varicocele. Consulting with a healthcare provider regarding the feasibility of varicocele repair could be a transformative step toward improving your sexual health.

Remember, you are not alone in this journey. Premature ejaculation affects approximately one-third of men, and the prevalence of varicocele is about 15% among males. As we strive to foster open conversations and continue research in this area, there is a beacon of hope for those struggling with these conditions.

References

  1. Kwak, T., Jin, M., Kim, J. et al. Long-term effects of glans penis augmentation using injectable hyaluronic acid gel for premature ejaculation. Int J Impot Res 20, 425–428 (2008). https://doi.org/10.1038/ijir.2008.26.
  2. Zhang, G-X et al. Selective resection of dorsal nerves of penis for premature ejaculation. Int J Androl. 2012 Dec;35(6):873-9.
  3. Ahmed, A.-F. et al. Impact of varicocelectomy on premature ejaculation in varicocele patients. Andrologia 2015, 47, 276–281.
  4. Hatzimouratidis, K. et al. EAU Guidelines on Erectile Dysfunction, Premature Ejaculation, Penile Curvature and Priapism. European Association of Urology 2016.

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