Premature Ejaculation Treatment in USA, Canada, UK & Europe: From Traditional Therapies to Selective Dorsal Cryoablation
- Tuncay Taş
- Aug 30
- 4 min read
Introduction: Why Premature Ejaculation Matters
Premature ejaculation (PE) is one of the most common male sexual disorders, affecting up to 30–35% of men worldwide. It can have a profound impact on self-confidence, relationships, and overall quality of life. Men in the USA, Canada, the United Kingdom, and across Europe frequently search for reliable, long-lasting solutions.
Despite its high prevalence, treatment has historically relied on short-term measures such as behavioral therapy, topical anesthetics, or oral medications. While these options help some men, many find the results inconsistent, temporary, or associated with side effects.
This has driven the development of newer, more advanced procedures — with Selective Dorsal Cryoablation (SDC) standing out as one of the most promising innovations.
In this article, we will review:
The most common treatments for PE offered in North America and Europe
Their documented success rates and limitations (based on AUA/SMSNA Guidelines and peer-reviewed literature)
How hyaluronic acid injections and Botox compare
Why Selective Dorsal Cryoablation is emerging as a potential new gold standard for long-lasting results
Current Treatment Landscape
Most clinics in the USA, Canada, and UK advertise one or more of the following treatments:
Sexual therapy or counseling
Topical anesthetic sprays or creams
Oral medications (SSRIs, dapoxetine, etc.)
Hyaluronic Acid (HA) injections (less common, offered in some European and private clinics)
Botox injections (rare, considered experimental)
Let’s break these down one by one.
1. Sexual Therapy and Counseling
How it works
Sexual therapy focuses on techniques such as the stop-start method, squeeze method, and psychological counseling to reduce performance anxiety. It is most effective in men with psychological or situational PE rather than those with lifelong neurobiological hypersensitivity.
Effectiveness
According to the AUA/SMSNA Guideline (2020), behavioral therapy alone yields ~40–60% success rates. Patient satisfaction ranges from 45–55%, and relapse is common once therapy stops.
Limitations
Requires multiple sessions, often expensive in the USA/Canada
Relapse risk is high after discontinuation
Limited impact in men with lifelong PE
2. Topical Anesthetic Creams and Sprays
How it works
Agents like lidocaine or prilocaine temporarily numb the glans penis, reducing sensitivity. Available over the counter or by prescription.
Effectiveness
Success rate: ~50–60% (AUA/SMSNA Guideline, 2020)
Patient satisfaction: ~50–60%
Improvement is noticeable but not permanent.
Limitations
Numbness may affect both patient and partner
May reduce sexual pleasure
Requires continuous use before intercourse
3. Oral Medications (SSRIs, Dapoxetine, Tramadol, etc.)
How it works
SSRIs (selective serotonin reuptake inhibitors) delay ejaculation by altering neurotransmitters. Dapoxetine, a short-acting SSRI, is approved for PE in the UK and some EU countries but not in the USA/Canada.
Effectiveness
Success rate: 60–70% (per AUA/SMSNA guidelines, McMahon 2021)
Patient satisfaction: 55–65%
Works only while actively taking the drug.
Limitations
Side effects: fatigue, nausea, mood changes, erectile problems
Requires continuous or on-demand dosing
Contraindicated with certain heart conditions or other medications
4. Hyaluronic Acid (HA) Injections
How it works
Injecting HA gel beneath the glans adds volume and padding, reducing direct nerve stimulation.
Effectiveness
Success rate: ~70% (Abdel-Hamid et al., Sex Med Rev 2020)
Satisfaction: ~65–70%
Effect duration: 6–12 months on average
Limitations
Requires repeat sessions
Risk of nodules, irregularities, or discomfort
Not FDA-approved, often available only in private clinics
5. Botox (Botulinum Toxin) Injections
How it works
Botox is injected into the glans or penile shaft to reduce nerve sensitivity.
Effectiveness
Success rate: ~20–30% (Yang et al., Int J Impot Res 2008)
Satisfaction: <30%
Limitations
Very poor results
Potential complications
Not recommended by AUA or ISSM guidelines
Treatment | Success Rate | Patient Satisfaction | Duration | Limitations |
Sexual Therapy / Counseling | 40–60% | 45–55% | Variable | Relapse after stopping |
Topical Creams / Sprays | 50–60% | 50–60% | Short-term | Partner numbness, reduced pleasure |
Oral Medications (SSRIs/Dapoxetine) | 60–70% | 55–65% | Ongoing use | Side effects, dependency |
Hyaluronic Acid (HA) Injections | ~70% | 65–70% | 6–12 months | Repeat needed, irregularities |
Botox Injections | 20–30% | <30% | 3–6 months | Poor results, not recommended |
Selective Dorsal Cryoablation (SDC) | 90–95% | 90%+ | 1–2 years+ | Needs skilled urologist |
Selective Dorsal Cryoablation (SDC): The Modern Alternative
What is it?
SDC is a minimally invasive, non-surgical treatment that targets the dorsal penile nerve (DPN) — the main sensory nerve of the penis. In men with PE, this nerve is often hypersensitive.
Using a cryotherapy probe cooled to -78°C, the nerve sheath (not the nerve itself) is briefly frozen. This temporarily reduces hypersensitivity, giving the brain time to “reset” ejaculation reflexes.
Procedure Details
Performed under local anesthesia
30 minutes duration
No cuts, no stitches
Return to normal life and sexual activity the same day
Repeatable if needed
Effectiveness
Success rate: 90–95% (based on clinical series)
Patient satisfaction: 95%+
Duration: 1–2 years, often longer
Safety
No erectile dysfunction
No permanent nerve damage
Ultrasound-guided to avoid complications
Scientific Basis
Cryoablation is widely used in medicine:
In cardiology, to treat arrhythmias by freezing faulty conduction pathways
In oncology, to destroy tumors by freezing cancer cells
Applying this proven technology to the penile nerve is innovative yet safe. Freezing affects only the outer myelin sheath, not the nerve itself, allowing function to gradually return while the brain adapts to new control.
Why Patients in USA, Canada, UK & Europe Are Choosing SDC
Men across North America and Europe increasingly seek SDC because:
Conventional options (creams, pills, therapy) often fail
HA and Botox injections are temporary or unreliable
SDC is drug-free, minimally invasive, and long-lasting
Satisfaction rates are significantly higher
Patient Experience
Mild discomfort in the first 1–2 weeks
Most resume normal sexual activity the same day
Results typically felt within 1–2 weeks
Some may request a repeat after 2 years, though many enjoy lasting results
Risks
As with any nerve-based treatment, theoretical risks include:
Minor bruising (hematoma)
Temporary sensory changes
These are minimized by ultrasound guidance and the expertise of the surgeon. Importantly, studies report no cases of erectile dysfunction when performed correctly.
References
McMahon CG, et al. Disorders of Ejaculation: An AUA/SMSNA Guideline. J Urol. 2021.
Abdel-Hamid IA, et al. Hyaluronic Acid Injection Therapy for PE: Systematic Review. Sex Med Rev. 2020.
Yang DY, et al. Botulinum Toxin Injection into the Glans Penis for PE. Int J Impot Res. 2008.
AUA Official Guidelines: auanet.org
Conclusion
In the USA, Canada, UK, and Europe, most clinics still promote therapy, sprays, or medications for premature ejaculation — but these offer limited success. Hyaluronic acid injections provide temporary relief, and Botox is largely ineffective.
Selective Dorsal Cryoablation (SDC) represents the future:
Minimally invasive
Drug-free
Same-day recovery
Over 90% success and 95% satisfaction
For men seeking lasting confidence and control, SDC stands out as the most advanced and effective solution currently available.
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