What question did this study set out to answer?

This study aims to assess the efficacy of glans penis augmentation (GPA) with distal penile girth enhancement (PGE) versus GPA alone for improving internal ejaculation latency time (IELT) in patients with premature ejaculation (PE).

June 6, 2026

(311) Efficacy of GPA With Distal PGE by HA for the Treatment of PE

Key Points

This study aims to assess the efficacy of glans penis augmentation (GPA) with distal penile girth enhancement (PGE) versus GPA alone for improving internal ejaculation latency time (IELT) in patients with premature ejaculation (PE).
Enrolled 20 patients with PE, IELT less than 3 minutes.
Performed GPA using submucosal injection of 4-6 ml Hyaluronic Acid (HA) over the glans.
Conducted distal PGE by injecting 10 ml HA around the distal penile shaft, assessing IELT and satisfaction at multiple time points.
Mean IELT significantly improved from 101.54±69.72 seconds before GPA to 251.4±72.3 seconds after GPA (p<0.001).
Another significant increase in IELT to 325.38±120.76 seconds occurred after distal PGE (p<0.001).
90% of patients reported satisfaction with penile shape and sexual satisfaction, with no serious adverse events reported.

Abstract

Abstract Introduction Glans Penis Augmentation (GPA) with Hyaluronic Acid (HA) has been reported for treatment of PE, in patients of nonresponsive to conventional treatment. Penile Girth Enhancement (PGE) and frenulectomy also has an effect to decrease IELT despite debate. Objective We performed this study to evaluate the efficacy of GPA with distal PGE compared to GPA alone for the treatment of PE. Methods A total of 20 patients of PE, IELT3min were enrolled in this study. GPA was done firstly with submucosal injection of 4-6ml of HA evenly whole glans surface and assessed change of IELT. Distal PGE was performed by circularly injecting 10 mL of HA gel around the distal penile shaft, including the ventral urethral and frenulum areas, to target frenulum sensitivity. Before GPA, 4 weeks after GPA and 4 weeks after distal girth enhancement with HA, IELT, 5 scale patient satisfaction on penile shape, sexual satisfaction and any adverse reactions were assessed. Results In all patients, distal penile girth significantly increased by 25.95±13.71 mm. Preoperative mean IELT was 101.54±69.72sec. 4 weeks after GPA, mean IELT significantly increased to 251.4±72.3sec. Another 4 weeks after distal PGE, mean IELT increased additionally 325.38±120.76 sec. 18/20(90%) of patients were satisfied in penile shape and sexual satisfaction. No serious adverse events (AEs) were reported. Conclusions This pilot study demonstrated that GPA effectively increased IELT in patients with PE and additional distal PGE with HA further increased IELT. Importantly, distal PGE avoided the unsatisfactory distal displacement of HA or distortion of outer appearance of penile body sometimes observed with total PGE. Disclosure No

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