Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Research
  • Published:

Effects of glans penis augmentation using hyaluronic acid gel for premature ejaculation

Abstract

The main limitation of medical treatment for premature ejaculation is recurrence after withdrawal of medication. We evaluated the effect of glans penis augmentation using injectable hyaluronic acid (HA) gel for the treatment of premature ejaculation via blocking accessibility of tactile stimuli to nerve receptors. In 139 patients of premature ejaculation, dorsal neurectomy (Group I, n=25), dorsal neurectomy with glandular augmentation (Group II, n=49) and glandular augmentation (Group III, n=65) were carried out, respectively. Two branches of dorsal nerve preserving that of midline were cut at 2 cm proximal to coronal sulcus. For glandular augmentation, 2 cc of HA was injected into the glans penis, subcutaneously. At 6 months after each procedure, changes of glandular circumference were measured by tapeline in Groups II and III. In each groups, ejaculation time, patient's satisfaction and partner's satisfaction were also assessed. There was no significant difference in preoperative ejaculation time among three groups. Preoperative ejaculation times were 89.2±40.29, 101.54±59.42 and 96.5±52.32 s in Groups I, II and III, respectively. Postoperative ejaculation times were significantly increased to 235.6±58.6, 324.24±107.58 and 281.9±93.2 s in Groups I, II and III, respectively (P<0.01). The percentage of postoperative satisfaction in both patient and his partner was 68% (17/25) and 44% (7/16) in Group I, 80% (39/49) and 66% (25/38) in Group II and 75% (49/65) and 62% (32/52) in Group III, respectively. Maximal glandular girth was significantly increased from 9.16±0.59 to 10.95±0.4 cm in Group II and 8.95±0.54 to 11.67±0.71 cm in Group III, respectively. These results suggest that glandular augmentation with injectable HA gel is a safe and effective modality to reduce sensory of glans penis. Long-term follow-up for residual volume and efficacy should be requested to establish its precise therapeutic potentials in premature ejaculation.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2

Similar content being viewed by others

References

  1. Xin ZC et al. Penile sensitivity in patients with primary premature ejaculation. J Urol 1996; 156: 979–981.

    Article  CAS  Google Scholar 

  2. Tullii RE, Guillaux CH, Vaccari R, Ferreira R . Premature ejaculation-selective neurectomy: a new therapeutic technique-base, indications and results. Int J Impot Res 1994; 6: 109–113.

    Google Scholar 

  3. Olenius M . The first clinical study using a new biodegradable implant for the treatment of lips, wrinkles, and folds. Aesth Plast Surg 1998; 22: 97–101.

    Article  CAS  Google Scholar 

  4. Duranti F et al. Injectable hyaluronic acid gel for soft tissue augmentation. Dermatol Surg 1998; 24: 1317–1325.

    CAS  PubMed  Google Scholar 

  5. Goa KL, Benfield P . Hyaluronic acid. A review of its pharmacology and use as a surgical aid in ophthalmology, and its therapeutic potential in joint disease and wound healing. Drugs 1994; 47: 536–566.

    Article  CAS  Google Scholar 

  6. Moon DG, Kwak TI, Kim JJ, Cho HY . Effects of hyaluronic acid gel in penile augmentation. Int J Impot Res 2002; 14(Suppl 3): S40.

    Google Scholar 

  7. Burton JL, Cunliffe WJ . The subcutaneous fat. In: Rook A, Wilkinson DS, Champion RH, Ebling FJG, Burton JL (eds) Textbook of Dermatology. Blackwell: Oxford, 1986, pp 1870–1871.

    Google Scholar 

  8. Knapp TR, Kaplan EN, Daniels JR . Injectable collagen for soft tissue augmentation. Plast Reconstruct Surg 1977; 60: 898–905.

    Google Scholar 

  9. Comper WD, Laurent TC . Physiological function of connective tissue polysaccharides. Physiol Rev 1978; 58: 255–315.

    Article  CAS  Google Scholar 

  10. Selmanowitz VJ, Orentreich N . Medical-grade fluid silicone: a monographic review. J Dermatol Surg Oncol 1977; 3: 597–611.

    Article  CAS  Google Scholar 

  11. Elson ML . Soft tissue augmentation. A review. Dermatol Surg 1995; 21: 491–500.

    CAS  PubMed  Google Scholar 

  12. Pollack SV . Silicone, Fibrel, and collagen implantation for facial lines and wrinkles. J Dermatol Surg Oncol 1990; 16: 957–961.

    Article  CAS  Google Scholar 

  13. Larsen NE et al. Hylan gel biomaterials: dermal and immunologic compatibility. J Biomed Mater Res 1993; 27: 1129–1134.

    Article  CAS  Google Scholar 

  14. Richter W . Nonimmunogenicity of purified hyaluronic acid preparations tested by passive cutaneous anaphylaxis. Int Arch Allergy Immunol 1974; 47: 211–217.

    Article  CAS  Google Scholar 

  15. Richter W, Ryde E, Zetterstrom EO . Nonimmunogenicity of purified sodium hyaluronate preparation in man. Int Arch Allergy Immunol 1979; 59: 45–48.

    Article  CAS  Google Scholar 

  16. Yang CC, Bradley WE . Neuroanatomy of the penile portion of the human dorsal nerve of the penis. Br J Urol 1998; 82: 109–113.

    Article  CAS  Google Scholar 

  17. Halata Z, Munger B . The neuroanatomical basis for the protopathic sensibility of the human glans penis. Brain Res 1986; 371: 205–230.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to D G Moon.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kim, J., Kwak, T., Jeon, B. et al. Effects of glans penis augmentation using hyaluronic acid gel for premature ejaculation. Int J Impot Res 16, 547–551 (2004). https://doi.org/10.1038/sj.ijir.3901226

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.ijir.3901226

Keywords

This article is cited by

Search

Quick links