The hypogastric nerve(Fig1) fibers shows crossing at bifurcation level and pelvic ganglia level, so cutting of the nerve at right side could be compensated, this inhibits emission phase. If we cut the nerves - bilaterally - retrograde ejaculation occurs, cutting bulbospongiosus muscles bilaterally with frenular delta excision inhibits expulsion phase (Fig3).

21 patients underwent surgery (2016/4/15 – 2016 /9/19) at Alaa clinic hospital, Egypt. Criteria: hetro sexual, age (22 – 54) no response to local anesthetics or good response to alcohol, ejaculation time less than 30 seconds.

one patient reported ejaculation time 20 minutes, nineteen patients reported ( 4-5 ) minutes, one patient reported one minute,Post - operative one patient reported partially wound dehesience (treated medically), in one patient reported inability to extend trunk completely (works as waiter) but he improved after three weeks. In one patient we can`t identify the hypogastric (right branch) due to extensive adhesions from previous surgeries, we didn’t excise it, so we cut bulbospongiosus muscles only - bilaterally - with frenular delta excision but the result was not enough as improvement was only one minute (previously ejaculation was before entrance) . One patient reported low semen volume. Laparoscope offers easy and simple way to operate the patients.

Alaa Aglan (7) operation allow bi-phasic control of ejaculation, more studies are needed to demonstrate its efficacy and safety.