Efficacy of hyaluronic acid local injection in treatment of lifelong premature ejaculation: A new protocol.

Aim: To discuss a new protocol of hyaluronic acid (HA) injection in terms of safety, efficacy and long-term benefits.

Methods: In all, 80 patients, 29-54 years old, with refractory premature ejaculation were included. All patients were given three sessions of HA injection, each session 2 weeks apart. Follow-up of intravaginal ejaculatory latency time (IELT) and glans circumference was done at 3, 6 and 12 months after the last session. Post-procedural complications were recorded.

Results: IELT highly significantly increased (P-value <0.001) after HA gel injection from baseline, 94.40 ± 5.645 sec at repeated measures, IELT measures after 3-, 6- and 12-month post-injection were 201.175 ± 2.765 s, 197.731 ± 2.539 s and 196.6 ± 3.224 s, respectively, with significant increase from pre-injection baseline one and with a significant yet minimal drop of 12-month versus 3 and 6 months measures. Maximum glans circumference was highly significantly increased (P-value <0.001) after HA gel injection from baseline, 96.072 ± 0.929 mm, at repeated measures after 3-, 6- and 12-month post-injection were 107.762 ± 1.548 mm, 111.582 ± 1.522 mm and 110.677 ± 1.552 mm, respectively, with significant increase from pre-injection baseline one and with a significant yet minimal drop of 12-month versus 6 months measure. 3.8% of patients suffered from ecchymosis, 1.3% had bullae formation at site of injection. All patients suffered from pain at site of injection.

Conclusion: Our new protocol of HA injection proved both safe and efficacious with long-term benefits in terms of IELT and glans circumference decreasing the future need for repeated injections of HA.