Hyaluronic acid injection in glans penis for treatment of premature ejaculation: a randomized controlled cross-over study

• Published in: International journal of impotence research Vol. 31; no. 5; pp. 348 - 355
• Main Authors: Alahwany, Amr, Ragab, Mohamed W., Zaghloul, Ahmed, Abdallah, Hamed, Mostafa, Taymour
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.09.2019; Nature Publishing Group
• Subjects: 692/308/2779/109; 692/699/2768/515; Adult; Clinical trials; Cross-Over Studies; Evidence-based medicine; Female; Humans; Hyaluronic acid; Hyaluronic Acid - administration & dosage; Hyaluronic Acid - adverse effects; Immunotherapy; Injections; Injections - adverse effects; Injections - methods; Male; Medicine; Medicine & Public Health; Mens health; Molecules; Penis; Premature Ejaculation - drug therapy; Prospective Studies; Reproductive Medicine; rology; Sexual disorders; Urology; Viscosupplements - administration & dosage; Viscosupplements - adverse effects
• ISSN: 0955-9930; 1476-5489; 1476-5489
• DOI: 10.1038/s41443-018-0104-9

This randomized controlled cross-over study aimed to assess the efficacy and safety of glans penis injection with hyaluronic acid (HA) in treating premature ejaculation (PE). A total of 30 patients with PE were randomly allocated into two groups: group 1 ( n  = 15) which was subjected to glans penis HA injection and group 2 ( n  = 15) which was injected with saline as a control then both groups were subjected to follow-up at 1 week and 1 month after injection. These subjects were evaluated by intra-vaginal ejaculation latency time (IELT) and the Arabic validated index of premature ejaculation (AIPE). After a wash-out period, cross-over and re-evaluation of both groups were carried. Additionally, patients with reported improvement after 1 month of HA injection ( n  = 20) were subjected to extended evaluation by IELT at 3, 6, and 9 months intervals. Two-way repeated measures ANOVA indicated significant improvement after HA in comparison with saline across the follow-up periods ( F (1.66: 91.37) = 24.85, p  = 0.001). Post-hoc Bonferroni test indicated no significant difference after 1 week period in comparison with baseline IELT, but a significant difference after 1 month of injection in comparison with baseline IELT ( p  < 0.001) and after 1 week ( p  < 0.001). After 1 month of HA, IELT increased by a median of 2.6 folds while 1.1 folds increase was observed after 1 month of saline injection. Total AIPE scores improved significantly after HA injection compared with baseline ( p  = 0.003) and saline scores ( p  = 0.002). Reported adverse effects were minimal and self-limited. It could be concluded that glans penis injection with HA for treatment of PE is a safe method that ensures a modest but significant increase in IELT and improves couple sexual satisfaction.