Injections of hyaluronic acid (HA) and polylactic acid (PLA) temporarily increased penile girth in men with small penis syndrome (SPS), according to a new Journal of Sexual Medicine study.
The effects lasted for the study’s 24-week duration, and no study participants experienced serious adverse events, researchers said. Many participants reported decreased levels of psychological distress.
Men with small penis syndrome feel anxious about their penis size, even when their penis measurements fall into a normal range. Education and psychotherapy are typical first approaches to treatment, but they are not effective for all patients.
Penile augmentation (PA) is another option. PA involves injecting a soft tissue filler into the penis. Such fillers are commonly used for other body areas like the face, but their use for PA has not been studied as thoroughly.
In this study, researchers compared the PA results for hyaluronic acid and polylactic acid. These fillers were chosen because they are both considered temporary, and they have been approved for PA in some countries.
Seventy-four men with small penis syndrome participated in the study, which took place at three Korean hospitals. The participants were randomly assigned to receive either HA or PLA for a soft tissue filler injection. The men were then followed for 24 weeks. The final analysis included data from 37 men from the HA group and 35 men from the PLA group.
Each man’s penile girth was measured before his injection, and again at 4-, 12-, and 24-week time points afterward. In addition, the men completed the Beliefs about Penile Size Scale (BAPS) assessment and reported on their penile appearance satisfaction. Satisfaction with sexual life was assessed at baseline and at the 12- and 24-week follow-up points.
After four weeks, penile girth had increased for both groups. By the 24-week mark, girth had increased an average of 2.1 cm for the HA group and 1.6 cm for the PLA group. The filler material appeared to be evenly distributed. Girth increases seemed to occur more quickly in men who received HA injections.
For both groups, satisfaction with penile appearance and satisfaction with sexual life had improved by the 4-week point as well. These results were maintained for the 24-week follow-up period.
Based on BAPS scores, the researchers found that the men’s feelings of insecurity and shame related to penis size had decreased by four weeks, with this improvement lasting through the 24-week time point.
The researchers noted that all participants received counseling before their injection, which could have contributed to improvements in psychological distress.
No serious adverse events were reported.
“PA can be considered an alternative approach in patients for whom psychological approaches fail,” the authors wrote. “However, PA should be used with caution, because PA is an invasive surgical treatment that can lead to complications.”
The researchers recommended that clinicians counsel patients on what can be expected from PA.
They also encouraged longer-term studies, as the 24-week duration in this study was “insufficient to prove the long-term clinical utility of both fillers.”
Resources
The Journal of Sexual Medicine
Yang, Dae Yul, MD, PhD, et al.
“A Comparison Between Hyaluronic Acid and Polylactic Acid Filler Injections for Temporary Penile Augmentation in Patients with Small Penis Syndrome: A Multicenter, Patient/Evaluator-Blind, Comparative, Randomized Trial”
(Full-text. Published online: November 14, 2019)
https://www.jsm.jsexmed.org/article/S1743-6095(19)31461-4/fulltext