Абстракт

Objectives: Injectable fat, poly-L-lactic acid (PLLA) and hyaluronic acid (HA) have been used for soft tissue augmentation of the glans and the shaft of the penis for more than a decade in the world. The terms "Small penis anxiety" have been used in sexology to refer to a man's excessive concern about the size and/or shape of his completely normal penis. The aim of our research was to achieve the enlargement effect of HA injection into the penis and to evaluate the improvement of the patients' psychosexual status. Introduction: This sometimes unfounded desire that men have to have “large sex organs” leads them to seek out and use augmentation methods that are often pseudo-scientific and non-medical. These interventions often cause inflammation, necrosis, deformation of the organ, and even a loss of erectile function. There are various surgical and non-surgical methods for lengthening and thickening of the penis. Although surgical methods have a positive effect, they give a certain percentage of complications. That's why we focused on injection. Materials / method: We used HA for penis girth enlargement in 39 patients who suffer from "Small penis anxiety". The method consists in injecting hyaluronic acid interfascially into the shaft of the penis and into the superficial layer of the glans. The total volume used for 1 patient was 14 ml. Measurements were performed 1 month and 10 months after the injection. The effectiveness was also evaluated with the Self-Esteem And Relationship (SEAR) questionnaire before and 3 months after the procedure. Results: Baseline mean penile girth was 7.8 ± 0.12 cm. 1 month after the injection – 9.55 ± 0.1 cm and 10 months – 9.05 ± 0.11 cm. Mean girth increase was 1.75 ± 0.12 cm and 1.25 ± 0.11 cm after 1 and 10 months, respectively. The complications after the procedure we observed in 2 patients: nodal formations and irregular filler distribution. These complications were resolved with hyaluronidase injections. Regarding the SEAR questionnaire, the satisfaction of sexual life and self-esteem improved significantly compared with the results before surgery by 8.6 ± 0.46 (P < 0.001) points. Conclusion: The data above shows that this method increases penile girth and the effect lasts more than 10 months without significant changes. This provides a more quick, visible and long-lasting cosmetic effect and, as a result, more satisfied patients. The injection method of penile augmentation significantly improves the psychosexual status of the patients. It could be considered for the management of small penis syndrome after more detailed research as a safe and effective alternative to conservative approaches to therapy. Other methods for penis enlargement are also discussed.