(399) Effect of Bulbospongiosus Muscles Cutting with Frenular Delta Excision for Treatment Premature Ejaculation ( Alaa Aglan Operation)
Authors: Aglan A 
Published: May 2023

Abstract

Introduction
Alaa aglan operation is a new procedure consists of two parts. First part is cutting bulbospongiosus muscles bilaterally, And 2nd part is cutting of elliptical part of frenular delta. it is the most sensitive area in penis and excision of its central part decreases penis sensitivity. The operation has it's own prediction test that allows us to know the expected time post operatively and if the operation is option or not. It is easy just spraying local anesthesia (procomail 10%®) at coronal ridge (inhibits glans-bulbospongiosus reflex) and at frenular delta (temporary excision) 30 minutes before having sex. The operation could be reversed by repairing the muscle again.

Objective
presentation of a simple, easy permanent solution for treatment of premature ejaculation with less side effects in comparison with all other treatments.

Methods
1050 Cases were operated between 1/1/2015 and 3/10/2015 follow up was done at 1, 3,6,12 months intervals then yearly (5 years duration). 47 Cases didn't complete the 5 years duration but none of them have any complain.

Results
There are two types of patients: First type (non-psychic causes patients) the gained time was approximately as prediction test of each. Second type (secondary psychic or mixed causes patients) the results were much better than prediction tests after 3 months. The non- psychic premature ejaculation patients improved quickly. we calculate the time (IVEL) from the second intercourse as patient usually be congested unless he masturbated or had wet dreams so we avoid the 1st intercourse and calculate the time from 2nd time .clinically we noticed that all patients gets the final result after 1 month approximately from day of surgery. And the result still constant without change or with minimal positive change in few cases but in second type patients the results after 3 weeks resembles the prediction test results but improves gradually till the 3rd month with final constant result. Satisfaction was rate 99.6% this is due to prediction test application, in our early trials beyond this study Satisfaction rate was 71% (without prediction test). Side effects were minimal, No regression in results in any patient during the following up period. Only 4 patients were not satisfied although the operation was successful. 1st patient complained from neuroma due to adhesion (post operative), Adhesiolysis was done, total relief of pain reported by the patient immediately post operative, 2nd patient reported that the distance of expulsion of semen from penile orifice decreased in comparison to that before surgery. 3rd patient reported hematoma, Evacuation was done without complications. 4th patient reported that he lost the sensation of repetitive contraction of muscles at peno-scrotal area during ejaculation. Many patients reported absence or decrease in number of wet dreams post operative other side effects were minimal.

Conclusions
Alaa aglan operation is safe, Immediate, Curative technique for premature ejaculation provided that prediction test shows good response.

Disclosure
No