The procedure for glans penis augmentation to treat premature ejaculation (PE) typically involves the injection of filler materials into the glans penis to reduce its sensitivity and prolong ejaculatory latency. Premature ejaculation (PE) is one of the most common male sexual disorders, significantly impacting quality of life and psychological well-being. Various treatment methods have been explored, including behavioral therapy, pharmacological interventions, and surgical options.

Among these, glans penis augmentation has emerged as a novel approach for managing PE. This technique involves increasing the volume or sensitivity threshold of the glans to prolong ejaculatory latency. By modifying tactile sensitivity, it offers a promising solution for patients seeking long-term results.

What is glans penis augmentation for PE?

This is a medical procedure aimed at managing premature ejaculation (PE) by altering the sensitivity or volume of the glans penis (the head of the penis). The glans plays a crucial role in sexual sensitivity, and excessive sensitivity can contribute to early ejaculation.

Hyaluronic acid (HA) is commonly used for glans penis augmentation. HA is biocompatible, absorbable gel that is widely used for aesthetic procedures. It is temporary but provides effective results.

Goals of the treatment:

• Reduce the sensitivity of the glans to delay ejaculation.
• Improve sexual confidence and satisfaction.
• Provide a minimally invasive, long-term solution for individuals not responding to conventional therapies like medications or behavioral techniques.

How to perform?

Glans penis augmentation is a minimally invasive procedure that should only be performed by trained professionals, such as urologists or specialists in sexual health. Below is a general outline of the steps involved in the procedure.

The area around the penis is thoroughly cleaned and sterilized using an antiseptic solution to minimize the risk of infection.

A local anesthetic (usually lidocaine) is applied to the glans penis to ensure the patient is comfortable and pain-free during the procedure. Some practitioners may also apply a topical numbing cream for additional comfort.

Using a fine needle or cannula, the selected filler material is injected into the subcutaneous tissue of the glans penis. The goal is to increase the volume of the glans slightly, reduce sensitivity, and create a more even texture.

Typically, multiple injections are required to ensure that the filler is distributed evenly. The filler may also be gently massaged or molded to ensure an even result and to prevent lumps or uneven contours.

Post-procedure care and long term considerations

Some issues that need to be taken into consideration after this procedure and in the long term should be taken into consideration:

• Immediate Aftercare:
  After the procedure, the patient may experience mild swelling, bruising, or redness, which typically subsides within a few days. A cold compress may be applied to the area to reduce swelling.

• Follow-up Appointments:
  The patient will usually need to return for follow-up visits to assess the results and ensure there are no complications, such as infection or filler migration.
• Avoid Sexual Activity:
  Patients are advised to avoid sexual activity for at least 1-2 weeks to allow the area to heal and to prevent pressure on the injected areas.
• Filler Absorption and Maintenance: The materials used for augmentation, such as hyaluronic acid, are gradually absorbed by the body over time. This means that the effects may wear off, requiring maintenance treatments to sustain the desired results.
• Need for Repeat Procedures: The temporary nature of the treatment may lead some individuals to require repeated sessions to maintain the effects. This could be an ongoing concern for some patients in terms of both cost and commitment.

How does it work?

The primary mechanism of action for this treatment lies in modulating the sensitivity of the glans penis to external stimuli. Premature ejaculation (PE) often results from heightened penile sensitivity, leading to a reduced latency time before ejaculation. Glans penis augmentation addresses this issue through the following mechanisms:

Reduction in Tactile Sensitivity:

• By injecting biocompatible fillers such as hyaluronic acid, collagen, or similar materials into the subcutaneous layers of the glans, the sensitivity of the glans to physical stimulation decreases.
  • The fillers create a cushioning effect, dampening nerve responses to stimuli, which can help delay the ejaculatory reflex.

Increased Glans Volume:

• The augmentation increases the physical size of the glans, slightly altering its shape and surface area. This may redistribute pressure during intercourse, contributing to longer latency periods.

Neuromodulation:

• The physical presence of fillers in the glans may interact with sensory nerve endings, reducing their responsiveness or altering the way tactile signals are transmitted to the central nervous system.
  • This reduced sensitivity disrupts the reflex arc responsible for rapid ejaculation.

Enhanced Psychological Confidence:

1. Although primarily a physical intervention, the treatment often boosts the patient’s confidence and reduces performance anxiety. This psychological benefit can further help delay ejaculation indirectly. who have not responded to traditional treatments.

Side effects and complications

While glans penis augmentation is generally considered a safe, minimally invasive procedure for treating premature ejaculation (PE), like all medical treatments, it comes with potential side effects and complications. These can range from mild and temporary issues to more serious, though rare, concerns.

Common side effects:

• Swelling and bruising: It is common to experience mild swelling or bruising around the treated area immediately after the procedure. This typically resolves within a few days to a week.
• Redness and sensitivity: Some patients may experience redness or sensitivity at the injection site, which may cause temporary discomfort. This is typically mild and subsides over time.
• Pain or discomfort: Mild pain or discomfort during and after the procedure is common, especially within the first few days. Most patients report this discomfort as manageable and temporary.
• Numbness or altered sensitivity: The procedure works by reducing the tactile sensitivity of the glans, but in some cases, excessive numbness or a loss of sensation can occur. This can be undesirable if it goes beyond the intended reduction in sensitivity.

Rare or Serious Complications:

• Infection: As with any procedure involving injections or alterations to body tissue, there is a risk of infection at the injection site. Symptoms of infection may include redness, pain, swelling, or the presence of pus. If not treated promptly, infections can lead to more serious complications like abscess formation.
• Allergic reactions to fillers: Some patients may have an allergic reaction to the filler material used (e.g., hyaluronic acid or collagen). Reactions could include itching, swelling, or rashes. Severe reactions are rare but could require discontinuation of the treatment and medical intervention.
• Filler migration or lumps: In rare cases, the filler material may migrate from the intended site, leading to irregularities in the shape of the glans. This could cause lumps, uneven contour, or an unnatural appearance. In such cases, corrective measures might be necessary, including massaging the area or, in extreme cases, removal of the filler.
• Erectile dysfunction: Although extremely rare, there is a potential risk that the procedure could affect erectile function, particularly if the procedure causes damage to the underlying tissue or nerve endings. However, most patients do not experience any long-term effects on erectile function.
• Scarring: If the procedure is not performed correctly, there is a risk of scarring or fibrosis. This can lead to long-term aesthetic or functional concerns.
• Changes in ejaculatory function: In some cases, the augmentation may lead to a reduction in ejaculatory intensity or difficulty reaching orgasm, as a result of altered sensory feedback. This could be perceived as an undesired side effect by certain individuals.

Summary

Treatment of premature ejaculation by glans penis augmentation is a minimally invasive procedure aimed at reducing the sensitivity of the glans penis to help delay ejaculation. The process involves injecting filler materials, such as hyaluronic acid or collagen, into the glans to increase volume and decrease tactile sensitivity. This can lead to prolonged ejaculatory latency and improved sexual performance.

While the procedure is generally safe, it carries potential risks like infection, allergic reactions, and irregular filler distribution. The results are often temporary, requiring maintenance treatments over time to sustain effectiveness.

Prof. Dr. Emin ÖZBEK

Urologist

Istanbul- TURKIYE