Kosseifi Fares, Chebbi Ala, Raad Nehme, Ndayra Antoinette, El Samad Raed, Achkar Kamal, Durand Xavier, Noujeim Antoine
Division of Urology, Department of Surgery, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon.
Department of Urology, Saint-Joseph Hospital, Paris, France.
Transl Androl Urol. 2020 Dec;9(6):2814-2820. doi: 10.21037/tau-20-1026.
Premature ejaculation (PE) is the most common self-reported male sexual disorder estimated to occur in approximately 5% of men in the general community. Penile hypersensitivity is thought to be an etiologic factor of lifelong PE. The role of glans penis augmentation using injectable hyaluronic acid (HA) for the treatment of PE is debatable and remains to be confirmed. The creation of a barrier at the level of the glans, by the bulking agent blocking accessibility and inhibiting the tactile stimuli to reach the dorsal nerve of the penis (branch of the pudendal nerve) receptors, is the theory behind the effectiveness of HA in the field of PE. We reviewed the literature using PubMed and searched for the following keywords: premature ejaculation, glans penis and HA, over the last 20 years. Five studies were found. These studies showed that HA injection could significantly increase IELT (2.43- to 4.46-fold), and this increase could persist for long term (up to 5 years). No serious adverse reactions were reported besides transient discoloration and swelling of the glans that recovered to normal within 2 weeks. Many techniques were discussed, their effectiveness remains to be proved. However, proper patient selection and mastering the esthetics of the technique, by adequate surgical training, is necessary in order to achieve the optimal results.
早泄（PE）是最常见的男性自我报告的性功能障碍，据估计，普通人群中约5%的男性患有此病。阴茎超敏反应被认为是终身早泄的一个病因。使用注射用透明质酸（HA）增大阴茎头治疗早泄的作用存在争议，仍有待证实。通过填充剂在阴茎头水平形成屏障，阻止可及性并抑制触觉刺激到达阴茎背神经（阴部神经分支）受体，这是HA在早泄领域有效性的理论依据。我们使用PubMed对文献进行了回顾，并在过去20年中搜索了以下关键词：早泄、阴茎头和HA。共找到五项研究。这些研究表明，注射HA可显著延长阴道内射精潜伏期（IELT）（提高2.43至4.46倍），且这种延长可长期持续（长达5年）。除了阴茎头短暂变色和肿胀在2周内恢复正常外，未报告严重不良反应。文中讨论了多种技术，但其有效性仍有待证明。然而，为了获得最佳效果，进行适当的患者选择并通过充分的手术训练掌握技术美学是必要的。
