Selective Dorsal Neurectomy (SDN) in Bangkok
A surgical option for men with persistent premature ejaculation — considered only after non-surgical treatments have been tried, and only when a urologist confirms it's appropriate.
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What Is Selective Dorsal Neurectomy?
Selective dorsal neurectomy is a microsurgical technique that aims to reduce penile sensitivity by selectively interrupting specific sensory branches of the dorsal nerve of the penis. The goal is to reduce excessive sensory signalling and improve ejaculatory control.
At HE Clinic, SDN is performed by Dr. Teanchai Siricharoensang, a urologist with 13 years of senior hospital experience. It is offered as a considered option for carefully selected patients — typically men whose premature ejaculation is persistent, significantly affects quality of life, and hasn't responded adequately to non-surgical treatment.
Not All Premature Ejaculation Is the Same
Premature ejaculation is the most common male sexual concern, affecting an estimated 30–40% of men at some point. But the right treatment depends entirely on which type you have — and what else is going on.
Present since your first sexual experiences
Often associated with heightened penile sensitivity and neurological factors. Research has suggested men with lifelong PE may have greater sensory nerve density than average — which is the rationale behind procedures that target those nerves.
Developed later, after a period of normal control
Frequently has an identifiable and treatable underlying cause — erectile dysfunction, thyroid or hormone issues, prostate inflammation, medications, stress, or relationship factors. Around 30% of men with PE also have concurrent ED. Treating the cause often resolves the symptom without surgery.
This is why an honest assessment comes first. Surgery is the wrong answer for a problem that has a simpler, reversible cause.
What We Try Before Considering SDN
Most premature ejaculation is first treated with behavioural techniques, counselling and medication — and combining approaches often works better than any single one. Selective dorsal neurectomy is considered only when these haven't delivered adequate improvement.
Why "Selective" Is the Important Word
The dorsal nerve runs along the upper surface of the penile shaft and carries sensation from the skin and glans. Working through a single small incision just below the glans, the surgeon identifies and treats only targeted sensory branches under magnification — the aim being to reduce excessive signalling while preserving the essential pathways that carry normal sensation.
SDN is not designed to guarantee a specific duration. Outcomes depend on individual anatomy, symptom type and severity, and contributing factors such as anxiety or co-existing erectile dysfunction.
The Procedure, Step by Step
Typically around one hour, under local anaesthesia — though this varies with individual anatomy and clinical complexity.
Assessment & Consent
A confidential consultation covering your symptoms, health history and previous treatments. Benefits, risks and aftercare are explained in full, and written informed consent is required.
Local Anaesthesia
You remain awake and comfortable — only the treatment area is numbed.
Small Incision
A small incision just below the glans provides access to the targeted area.
Nerve Identification
Under magnification, the surgeon identifies the relevant sensory branches. Precision here is what protects the essential pathways.
Selective Neurectomy
The identified branches are selectively treated to reduce excessive sensory signalling.
Closure & Aftercare
The incision is closed with attention to healing and infection prevention, and you receive written aftercare instructions plus a follow-up review.
Is Selective Dorsal Neurectomy Right for You?
SDN may be considered if you:
SDN may be less appropriate if:
Risks You Should Know Before Deciding
SDN is surgery, and every surgery carries risk. Your doctor will discuss each of these with you in detail before you decide anything.
Selective dorsal neurectomy is an alternative procedure and is not included in standard international medical guidelines for premature ejaculation. Major guidance bodies recommend behavioural, psychological and pharmacological treatment as first-line care. We publish this openly because you deserve to make this decision with the full picture. A thorough consultation well in advance of any procedure is essential, and a signed patient consent form is required.
Selective Dorsal Neurectomy Price
- Performed by senior urologist Dr. Teanchai
- Local anaesthesia — approximately one hour
- Written aftercare instructions & follow-up review
- Private, men-only licensed clinic in Thonglor
Consultation is free and carries no obligation. If your doctor believes a non-surgical approach would serve you better, that's what we'll recommend.
Selective Dorsal Neurectomy — FAQ
Who is selective dorsal neurectomy actually for?
Men with persistent or severe premature ejaculation that significantly affects quality of life, who have already tried appropriate non-surgical options without adequate improvement, and who are medically suitable for a minor procedure. If you haven't worked through the earlier steps, we'll start there instead.
Will I lose sensation?
The intent of the procedure is to reduce excessive sensitivity while preserving normal sensation — which is why only selected branches are treated, under magnification. However, changes in sensation are a recognised risk: sensation may end up reduced, uneven or altered. This is permanent, and it's the single most important trade-off to understand before consenting.
Is it reversible?
No. Nerve branches that have been treated cannot be restored, so SDN should be approached as a permanent decision. That's precisely why our consultation focuses on confirming that non-surgical options have genuinely been tried first.
How long does the procedure take, and what's recovery like?
The procedure itself typically takes around an hour under local anaesthesia. You'll receive written aftercare instructions covering wound care, activity, and when sexual activity can resume, plus a scheduled follow-up review. Your surgeon will give you the specific timeline for your case at consultation.
Will it guarantee I last a certain length of time?
No, and any clinic promising a specific number is overselling. SDN is not designed to guarantee a duration. Outcomes vary with individual anatomy, the type and severity of your symptoms, and contributing factors such as anxiety or co-existing erectile dysfunction.
Why does your page say SDN isn't in standard guidelines?
Because it isn't, and you should hear that from us rather than discover it elsewhere. International guidance recommends behavioural, psychological and medical treatment as first-line care for premature ejaculation; surgical approaches are considered alternative. We offer SDN for carefully selected patients who have exhausted those options — with full disclosure, informed consent, and an honest conversation about what it can and cannot do.
Talk to a Urologist At a Visit
Book a private consultation with Dr. Teanchai. We'll work out what type of premature ejaculation you have, what's driving it, and whether selective dorsal neurectomy is genuinely the right answer for you — or whether something simpler is.
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