Efficacy of GPA With Distal PGE by HA for the Treatment of PE

초록

Introduction: Glans Penis Augmentation (GPA) with Hyaluronic Acid (HA) has been reported for treatment of PE, in patients of nonresponsive to conventional treatment. Penile Girth Enhancement (PGE) and frenulectomy also has an effect to decrease IELT despite debate. Objective: We performed this study to evaluate the efficacy of GPA with distal PGE compared to GPA alone for the treatment of PE. Methods: A total of 20 patients of PE, IELT <3min were enrolled in this study. GPA was done firstly with submucosal injection of 4-6ml of HA evenly whole glans surface and assessed change of IELT. Distal PGE was performed by circularly injecting 10 mL of HA gel around the distal penile shaft, including the ventral urethral and frenulum areas, to target frenulum sensitivity. Before GPA, 4 weeks after GPA and 4 weeks after distal girth enhancement with HA, IELT, 5 scale patient satisfaction on penile shape, sexual satisfaction and any adverse reactions were assessed. Results: In all patients, distal penile girth significantly increased by 25.95 ±13.71 mm. Preoperative mean IELT was 101.54 ±69.72sec. 4 weeks after GPA, mean IELT significantly increased to 251.4 ±72.3sec. Another 4 weeks after distal PGE, mean IELT increased additionally 325.38 ±120.76 sec. 18/20(90%) of patients were satisfied in penile shape and sexual satisfaction. No serious adverse events (AEs) were reported. Conclusions: This pilot study demonstrated that GPA effectively increased IELT in patients with PE and additional distal PGE with HA further increased IELT. Importantly, distal PGE avoided the unsatisfactory distal displacement of HA or distortion of outer appearance of penile body sometimes observed with total PGE.