Hyaluronic Acid Gel Implants

Several different medication interventions have been studied and found to effectively treat premature ejaculation. Unfortunately, as soon as the patient stops taking the medication, the condition returns to its pre-treatment stage. Researchers in Korea tested hyaluronic acid gel implants in an attempt to bring about more lasting change for those who are affected by premature ejaculation. This study was conducted under the controversial theory that premature ejaculation is caused by penile hypersensitivity.

Researchers separated 139 patients with premature ejaculation into three treatment groups. Group I (25 patients) received a dorsal neurectomy only, a surgical procedure that cuts the nerves near the circumcision point that are thought to contribute to hypersensitivity of the penis, thereby causing premature ejaculation. Group II received a dorsal neurectomy and glans penis augmentation using hyaluronic acid gel. Finally, Group III received augmentation only. The augmentation was performed through injecting the hyaluronic acid gel approximately one-third from the tip of the glans to the coronal sulcus. Physicians “fanned” the hyaluronic acid gel to provide consistent implant material throughout the glans penis.

Researchers used a biothesiometer to determine the vibratory threshold of the penis at six months after the dorsal neurectomy and the glans augmentation. They also measured ejaculatory latency, patient satisfaction, and partner satisfaction. In Groups II and III researchers also measured changes in the glandular diameter in order to determine the residual volume of the implant. They also asked patients themselves to make a visual assessment of the amount of augmentation that remained after six months.

Results of the study revealed that all three groups experienced significant increase in ejaculatory latency. Group I latency was 89.2 seconds before neurectomy and 235.6 seconds after. Group II’s latency time ws 101.5 seconds before neurectomy and glans augmentation and 324.2 seconds after. Finally, Group III had ejaculatory latency of 96.5 seconds before augmentation and 281. seconds after. Patient satisfaction was highest in Group II with 80% vs. 68% in Group I and 75% in Group III. Partner satisfaction was also highest in Group II with 66% reporting satisfaction vs. 44% in Group I and 62% in Group III.

There were adverse reactions in both Groups I and Group II. These reactions included numbness, paresthesia, pain for neuroma, and Peyronie’s disease. There was not a long-term follow-up to determine the amount of time that the implants were still in place since hyraluronic acid gel will slowly “digest” over time and be absorbed into the body. Researchers did note that informal follow-up at one year demonstrated that the implants were still in place and “well maintained.” None of the men who participated in the study reported “abnormal reaction in the area feeling, texture and color.” Any initial discoloration caused by the temporary swelling of the glans penis reverted to pre-operation state within two weeks.

While this treatment is not for every man who experiences premature ejaculation, researchers demonstrated that the most effective method is augmentation and dorsal neurectomy. The major limitations reported by researchers include: “invasiveness, side effects, and possibility of further sensory loss in longer period.” The implant material itself is not harmful and seems to maintain its size over a relatively long period of time.

Source:

Kim, J.J., et. al. “Effects of Glans Penis Augmentation Using Hyaluronic Acid Gel for Premature Ejaculation.” International Journal of Impotency Research, 2004, 16 (6), p. 547-551.

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