Treatment of premature ejaculation by glans penis augmentation using hyaluronic acid gel: a pilot study

Abstract

Premature ejaculation (PE) is by far the most common male sexual complaint, with millions of men affected all over the world. It is estimated that up to 20-30% of all men may be suffering from various forms of PE. A variety of filler materials are widely used nowadays for soft tissue augmentation. The appropriate filler can restore symmetry, volume and create a smooth skin surface The aim of this pilot study was to evaluate the therapeutic effect of hyaluronic acid gel injection in patients with PE. Sixty men with self-reported PE who were referred to our outpatient andrology clinic (between January 2007 and January 2008) were included in this study. Participants were randomly assigned using random sampling numbers into two distinct groups. Group A (n = 30) received a single injection of 2 ml of hyaluronic acid gel (Hyalift 3.5% micronised hyaluronic acid) using the previously described fan technique. Group B (n = 30) received a single injection of 2 ml of hyaluronic acid gel using the multiple puncture technique. Twenty-three patients (46.9%) received injection by the fan technique, while 26 patients (53.1%) received it through the multiple-point technique. The mean intravaginal ejaculation latency time (IELT) increased significantly from 2.12 ± 1.16 to 7.71 ± 7.86 min, after 1 month of injection and then dropped to 5.32 ± 3.52 min, but still remaining significantly higher than the baseline values. Results from our present pilot study demonstrated the usefulness of the application of hyaluronic acid dermal fillers in the treatment of PE; however, further investigations in large cohorts with longer follow-up are definitely needed to obtain more consistent results.

A clinical study to assess the effectiveness of a hyaluronic acid-based procedure for treatment of premature ejaculation

“…1, 2 A definition of PE has not been standardized yet 3 because of the large and controversial debate surrounding this term. However, in medical practice, this term is commonly defined as ‘the ejaculation that regularly occurs at or around initial vaginal penetration', 4 and it is not the result of a prolonged absence from sexual activity.…”

“…1 Filler materials have been extensively used for soft tissue augmentation in aesthetic surgery, but it is only recently that they have found an important application in the field of glans penis augmentation allowing to achieve a volume sufficient to prevent PE. 2, 6 Abdallah et al 2 evaluated the effect of hyaluronic acid in 60 men affected by PE, demonstrating that intravaginal ejaculation latency time (IELT) increased 1 month after the injection of the compound in their penis. Furthermore, in 2008, another study 6 reported positive results in a 5-year long-term study in which hyaluronic acid gel was injected in 38 men.…”

Surgery is not indicated for the treatment of premature ejaculation

“…If the outcome is solely based on the results of observational studies, as observed in the HA gel literature to date, a vulnerable methodology makes it difficult to decipher between what is the result of treatment, and the result of faulty associations. As an example, while the previously described HA gel treatment 5-year follow-up study showed no difference in IELT when compared to immediate post-op IELTs, a more recent pilot study from 2012 documented that the IELT had dropped from 7.71 min post-op to 5.32 min after just three months, demonstrating need for follow-up (8). Additionally, similar to the previous argument against the results with DNN, all studies for HA gel augmentation was conducted in single center institutions, and with a relatively small sample size.…”

The characterization, current medications, and promising therapeutics targets for premature ejaculation

“…Complications are very rare and easily manageable by expert surgeons (Littara et al, 2013). Filler materials have shown an important role in the field of glans penis augmentation and was found to prevent PE (Kwak et al, 2008;Abdallah et al, 2012). Hyaluronic acid injection can be effectively used for treatment of PE allowing an increase in IELT.…”