Alaa Aglan(8) is a new operation in this operation we cut right hypogastric nerve (Fig1). Just after hypogastric trunk bifurcation (inhibits emission phase), Frenula delta excision(Fig2) and neurectomies(Fig3) around penis are done (dorsal, ventral or both) - inhibits expulsion phase – as the glans-bulbospongiosus reflux is mediated by pudendal branches at penis also this decreases signaling to the brain.

21 patients underwent surgery (2016/5/11 – 2016/12/5) at Alaa Clinic Hospital, Egypt.

after six months follow up period, nineteen patients reported ejaculation time more than three minutes up to seven minutes, one patient reported two minutes, one patient reported one minute, Numbness was reported in four patients (improved within three months), neuroma was reported in one patient, and re-excision of proximal end of nerve was done under local anesthesia after two months with excellent improvement. In one patient, we found the right side branch of hypogastric nerve well developed and larger than left branch so we didn’t cut it and we did dorsal and ventral neurectomies around penis. We cut the right hypogastric nerve immediately after of the trunk. The crossing of nerve fibers allows compensating unilateral cutting. We cut the right side, this inhibits emission phase, bilateral cutting cause’s retrograde ejaculation.

Alaa Aglan (8) operation is a promising option for treatment of premature ejaculation; more studies are needed to enable us to know its safety and efficacy.