RESUMO
PURPOSE: We evaluated the effect of injectable hyaluronic acid gel(HA) for augmentation of the glans penis and treatment of premature ejaculation. MATERIALS AND METHODS: In 139 patients with premature ejaculation, dorsal neurectomy(Group I; n=25) and glandular augmentation using HA(Group II; n=114) were done. Six months after each procedure, ejaculatory latency, penile vibratory threshold, and patient and partner satisfaction were assessed in both groups. RESULTS: There was no significant difference in preoperative ejaculation time in the two groups, being 89.2+/-40.3 sec in Group I and 96.5+/-52.3 sec in Group II. Postoperatively, ejaculatory latency was significantly increased, to 235.6+/-58.6 sec in Group I and 324.2+/-107.6 sec in Group II(p<0.01). The postoperative vibratory threshold was also significantly increased in both groups(p<0.01). Satisfaction was expressed by both the patient and his partner in 68%(17/25) and 44%(11/25), respectively, in Group I and 79.8%(91/114) and 64.0% (73/114) in Group II. The maximal glandular girth was significantly increased, from 9.2+/-0.6 cm to 11.0+/-0.4 cm, in Group II. CONCLUSIONS: Glandular augmentation with injectable HA gel appears to be very effective for the treatment of premature ejaculation. Glandular augmentation with a bulking agent is anticipated to replace the hazardous, irreversible dorsal neurectomy.