Premature ejaculation is one of the most common problems we encounter in men’s sexual health and is a condition that directly affects 1 in 3 men over the course of their lives. This issue is complex in both its medical and psychological dimensions; however, with the right diagnosis and a personalized treatment plan, it can be successfully managed in the vast majority of cases. In this article, I will discuss in detail the cryoablation method for treating premature ejaculation—a technique that has garnered increasing attention in recent years—based on my own clinical experience and the scientific literature.

My goal is to provide all my patients seeking information on this topic with clear, scientific, and accessible explanations, and to outline the available treatment options.

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Premature ejaculation is the uncontrolled ejaculation that occurs very shortly after the penis enters the vagina—often within a few seconds or a minute. The main issue here is often the inability to stop ejaculation, that is, the feeling of “loss of control.”

The main factors contributing to this situation are:

One of the most important biological mechanisms underlying premature ejaculation is hypersensitivity of the glans (head of the penis) and increased sensitivity of the dorsal nerve.

This nerve, which runs through the tip of the penis, is the fastest pathway for transmitting stimulation. If the nerve endings are overly active or hypersensitive, the penis becomes aroused more quickly than normal, and the brain interprets this signal as an ejaculation.

•Performance anxiety

•Fear of loss

•Stress from the first sexual encounter

•“Anticipatory anxiety” resulting from a history of premature ejaculation

These situations weaken the brain's control mechanism.

•Low testosterone

•Abnormalities in thyroid hormones (particularly hyperthyroidism)

may affect the discharge rate.

In men with chronic prostatitis, excessive tension in the pelvic muscles can cause ejaculation to occur more quickly.

Excessive sensitivity in the central nervous system triggers the ejaculation reflex.

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The foundation of treatment is accurately assessing the patient. In my clinical practice, I always approach the treatment of premature ejaculation using a personalized algorithm.

Main methods:

•Medication treatments (dapoxetine, daily SSRIs)

•Topical anesthetic creams / sprays

•Penile sensitivity measurement (Penile Sensometer)

•Hyaluronic acid filler for the glans area

•ESWT (shock wave) therapy

•Sex therapy techniques

•Hormone therapy

•Treatment of prostatitis

•Nerve freezing (cryoablation)

•Lifestyle changes

In this article, I will focus specifically on the nerve-freezing method; however, I will also explain in detail how the methods are combined with one another.

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We now know that the main cause of premature ejaculation in many men is above-normal sensitivity at the tip of the penis.

To measure this, I use a special device called a penile sensometer in my clinic. This device allows us to determine the level of sensitivity by measuring the nerve response threshold in the glans region.

If sensitivity is high, I plan the treatment to reduce it. This is exactly where nerve freezing comes into play.

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Nerve freezing is a minimally invasive procedure known in the medical literature as dorsal nerve cryoablation. The basic principle is as follows:

The nerve endings that cause the head of the penis to be hypersensitive

Slowing it down at a low temperature for a short period of time and in a controlled manner.

In this case, the nerve is not completely destroyed; nerve conduction is merely temporarily reduced. Over time, the nerve regenerates, but sensitivity returns to a level close to normal.

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I'm performing the procedure using the following steps:

First, I identify the points where the nerve branches pass through.

These lines are defined using ultrasound, anatomical landmarks, and sensor data.

The patient feels nothing. It’s as comfortable as a simple filling.

A thin probe, 1–2 mm in diameter, is placed close to the superficial branches of the dorsal nerve.

The probe tip is cooled to approximately –70°C.

This temporarily halts nerve transmission.

The entire process takes 10–20 minutes.

Patients walk out after the procedure and return to their daily lives.

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•Initial effect: 1–2 weeks

•Strongest effect: 1–3 months

•Total duration of effect: may vary between 4 and 12 months

•In some patients, it has been observed to last up to 18 months.

Sensitivity remains low until the nerve has fully regenerated.

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•The procedure is quick, convenient, and comfortable

•Does not require general anesthesia

•It doesn't disappear completely; it just becomes less extreme

•There are no systemic side effects

•It is renewable (the nerve regenerates over time)

•It is highly effective in cases of sensitivity-related premature ejaculation

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I would like to state clearly that:

•Long-term scientific data is limited

•It may not have the same effect in every patient

•The effect is temporary; it can be repeated if necessary

•Numbness may be slightly more pronounced than expected (usually temporary)

•In cases where premature ejaculation has psychological or hormonal causes, this alone is not sufficient

For this reason, it is essential to apply this treatment only to the right patients.

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Eligible individuals:

•People with excessive sensitivity of the glans

•Those who do not derive sufficient benefit from medications

•Those seeking a reversible treatment

•Patients with a low threshold on sensometer testing

Those who are ineligible:

•Those with severe erectile dysfunction

•People with penile curvature

•Those who already have low sensitivity in the glans

•Those who experience entirely psychological premature ejaculation

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Most of the time, no.

The treatments with the strongest clinical outcomes are combination therapies.

The most effective combination is as follows:

1. Sensitivity Measurement Using a Sensometer

2. As-needed medication (dapoxetine)

3. Glans augmentation, if necessary

4. Nerve Freezing

5. Sex therapy techniques

This approach significantly increases the success rate in treating premature ejaculation.

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Glans augmentation also reduces sensitivity, but the mechanism is different:

Feature: Glans Augmentation, Nerve Freezing

Mechanism: Physical cushioning effect; Slowing of nerve conduction

Duration of effect: 12–24 months; 4–12 months

Materials Used: Hyaluronic Acid, Cryo Energy

Suitable patients: May have hypersensitivity + aesthetic concerns; those with predominant nerve hypersensitivity

For many patients, the results are better when both are done together.

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Cryoablation has been used in medicine for many years; it is frequently used, particularly for treating pain in peripheral nerves. However, the nerve-freezing method for treating premature ejaculation is a more recent development.

In recent scientific publications:

•Effective at reducing sensitivity

•High patient satisfaction after the procedure

•The complication rate is low

•A repeatable method

is defined as.

It has not yet been accepted as a “standard treatment.” This means it is still open to further development.

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As Prof. Dr. Volkan İzol, I perform this procedure on selected patients at my sexual health center in Adana.

I now know very clearly which patients it works best for:

The group with which I achieved successful results:

•Those who are highly sensitive

•Those who scored low on the sensor test

•Those who have previously had glans augmentation and were satisfied with the results (but want a more pronounced effect)

•Patients who cannot take medication or who experience side effects

The results in this group are quite encouraging.

Group requiring special attention:

•Premature ejaculation caused solely by psychological factors

•Patients with a low pain threshold

•Those who previously had reduced sensitivity in the glans

In this group, it is essential to conduct a detailed assessment before proceeding.

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•Do not put weight on the area for the first 24 hours

•Avoid excessive heat, such as hot showers and saunas (for 48 hours)

•Sexual intercourse usually occurs 3–5 days later

•It is normal for the sensation to diminish during the first few weeks

•It may take 2–3 weeks for the full effect to set in

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No. It is completely comfortable with local anesthesia.

No. It only reduces hypersensitivity.

The natural feel is preserved.

It can have a positive effect; as anxiety about premature ejaculation decreases, erections become more stable.

Yes. If necessary, it can be repeated after 8–12 months.

No. Nerve tissue regenerates over time; the effect is temporary but long-lasting.

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Cryoablation: A Powerful Option in Modern Treatment of Premature Ejaculation

Nerve freezing for premature ejaculation is a highly effective treatment when the right patients are selected. It provides controlled and long-lasting relief, particularly for men with high penile sensitivity.

I use this method in my own practice:

•sensometer measurement,

•glans augmentation, if necessary,

•medication,

•sex therapy protocols

I've noticed that when I combine it with this, the success rates go up significantly.

Treatment for premature ejaculation is no longer a one-dimensional approach; it requires a multi-layered treatment plan that takes biological, neurological, and psychological factors into account.

All the information I’ve shared in this article is intended to help my patients embark on their treatment journey with greater awareness and confidence.