Karamık Kaan, Yıldız Ali, Koraş Ömer, Arslan Murat
Department of Urology, Kemer State Hospital, Antalya, Turkey.
Department of Urology, Okan University, Faculty of Medicine, Istanbul, Turkey.
Urol Int. 2025 Jul 12:1-5. doi: 10.1159/000547421.
Premature ejaculation is a common problem in men and filler injection into the glans penis has become a prevalent practice in treatment. Since the glans penis augmentation is an invasive treatment method, it also carries the risk of complications. Herein, we aimed to present a case of glans penis ischemia due to hyaluronic acid filler injection.
The patient was a 29-year-old male with premature ejaculation. The physical examination was normal, and sensory testing with a biothesiometer revealed vibration perception threshold values of 5.3V for the glans, 4.1V for the frenulum, and 3.9V for the penile shaft. Under local anesthesia, hyaluronic acid filler was applied with the multiple puncture technique, 2 mL in total, 0.2 mL per injection. One day after the procedure, the patient referred with complaints of discoloration of the glans penis. The physical examination revealed blackening at the distal tip of the glans with a visible demarcation line. Hyaluronidase was applied for the treatment of glanular glans penis ischemia secondary to hyaluronic acid filler injection. A significant improvement in the glans penis color was observed after hyaluronidase injection. The patient was prescribed 100 mg of aspirin, a warm saline dressing, and a nitroglycerin-containing cream and was discharged for daily follow-up.
Although vascular complications are rare after hyaluronic acid filling into the glans penis, early diagnosis and treatment are crucial. Patients should be informed about possible adverse events. The main treatment method for vascular complications is urgent hyaluronidase injection. In addition, prevention of clot propagation with oral aspirin and vasodilatation treatments should be applied. In the glans penis ischemia after hyaluronic acid injection, early diagnosis and immediate hyaluronidase administration can reverse ischemia without necrosis or surgical intervention.
早泄是男性常见问题，向阴茎头注射填充剂已成为一种普遍的治疗方法。由于阴茎头增大术是一种侵入性治疗方法，它也存在并发症风险。在此，我们旨在介绍一例因注射透明质酸填充剂导致阴茎头缺血的病例。
患者为一名29岁早泄男性。体格检查正常，使用生物感觉阈值测量仪进行感觉测试显示，阴茎头的振动感觉阈值为5.3V，系带为4.1V，阴茎体为3.9V。在局部麻醉下，采用多点穿刺技术注射透明质酸填充剂，总量2 mL，每次注射0.2 mL。术后一天，患者因阴茎头变色前来就诊。体格检查发现阴茎头远端尖端变黑，有明显分界线。应用透明质酸酶治疗透明质酸填充剂注射继发的阴茎头缺血。注射透明质酸酶后，阴茎头颜色有显著改善。给患者开了100 mg阿司匹林、温盐水敷料和含硝酸甘油的乳膏，并让其出院进行每日随访。
尽管向阴茎头注射透明质酸后血管并发症罕见，但早期诊断和治疗至关重要。应告知患者可能的不良事件。血管并发症的主要治疗方法是紧急注射透明质酸酶。此外，应采用口服阿司匹林预防血栓形成和血管扩张治疗。在透明质酸注射后阴茎头缺血的情况下，早期诊断并立即给予透明质酸酶可逆转缺血，避免坏死或手术干预。
