Clinical use of hyaluronic acid in andrology: A review

Zucchi, Alessandro; Scroppo, Fabrizio Ildefonso; Capogrosso, Paolo; Salonia, Andrea; Duante, Jacopo; Bini, Vittorio; Liguori, Giovanni; Bartoletti, Riccardo

doi:10.1111/andr.13083

Cited by 16 publications

(10 citation statements)

References 58 publications

(116 reference statements)

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“…As reported in Figure 2, in this study, we observed a significant increase in IELT after one month, as well as in PEDT and IIEF subscales regarding satisfaction (Table 3), and, even if we observed a gradual decrease in IELT, at three months post-injection IELT reported by patients was still significantly higher than baseline. Our preliminary results agree with previous studies obtained by using different techniques of HA injection; in particular, to date, three prospective single-arm studies [20,22,23], one randomized non-controlled trial [24], and one randomized controlled trial [25] demonstrated that HA treatment improved IELT, that it was safe and well-tolerated, showing lasting effects up to 6-12 months follow-up and with reported side effects ranging from 0% to 30% across all studies [26].…”

Section: Discussionsupporting

confidence: 91%

Effects of One-Shot Hyaluronic Acid Injection in Lifelong Premature Ejaculation: A Pilot Study

et al. 2022

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The therapeutic management of premature lifelong ejaculation (PE) ranges from behavioral therapy to pharmacological and surgical treatments. Hyaluronic Acid (HA) injection into the glans penis is a non-surgical procedure, intended to reduce glans hypersensitivity, improving the intravaginal ejaculation latency time (IELT). HA injection can be performed through different techniques that, although safe and effective, rarely can cause local complications. In this pilot uncontrolled study, we tested the effectiveness of a new technique based on a single HA injection into the frenulum of the glans, to improve IELT in a sample of patients affected by PE. We observed a significant increase of the IELT after one (median 73.3, IQR 66.2–79.9 s) and two months (66.2, 63.1–73.9) that gradually decreased at three months, remaining still significantly higher than at baseline (34.8, 30.9–37.4). PEDT and IIEF questionnaires significantly improved compared to baseline in the first two months of follow-up (p < 0.001). In conclusion, the preliminary results emerging from this pilot uncontrolled study, highlight the effectiveness of this one-shot HA injection approach, although a larger sample and longer follow-up time are needed to standardize the procedure.

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Section: Discussionsupporting

confidence: 91%

Effects of One-Shot Hyaluronic Acid Injection in Lifelong Premature Ejaculation: A Pilot Study

et al. 2022

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“…Surgical treatment for PD is most definitive but is reserved for those with stable disease. For patients with acute phase PD, some non-surgical and minimally invasive treatment options include L-citrulline, pentoxifylline, vitamin E, and intralesional interferon-α2b, verapamil, or hyaluronic acid (15,(18)(19)(20)(21)(22)(23).…”

Section: Introductionmentioning

confidence: 99%

Intralesional collagenase Clostridium histolyticum for acute phase Peyronie’s disease: a single-center, retrospective cohort study

Hu¹,

Sigalos²,

Walker³

et al. 2022

Transl Androl Urol

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Background: Peyronie's disease (PD) can be subdivided into acute and chronic phases. Intralesional collagenase Clostridium histolyticum has been shown to improve curvature in the chronic phase. Initial clinical trials excluded patients in the acute phase from treatment. Recent studies show comparable results among men in the acute phase. The definition of acute phase varies among existing studies, but it is generally understood to last 12-18 months and is accompanied by penile pain and progression of deformity. We sought to evaluate the safety and efficacy of intralesional collagenase injection therapy during the acute phase of PD using multiple definitions of the acute phase.Methods: All men receiving intralesional collagenase for PD from October 2015 through December 2020 at a single academic institution were retrospectively assessed for patient demographics and comorbidities, pre-and post-treatment curvature, and adverse events. Two definitions of acute phase were used: (I) acute phase duration ≤6 months, chronic phase duration >6 months; and (II) acute phase duration ≤12 months with penile pain, chronic phase duration >12 or no penile pain.Results: Of 330 patients identified, 229 underwent intralesional collagenase treatment with pre-and post-treatment erect penile goniometry. 65 (28%) met criteria for definition 1 of acute phase, 37 (16%) met criteria for definition 2, and 76 (33%) met criteria for either. Percent change in penile curvature was not significantly different between acute and chronic phases using definition 1 (16.0% vs. 16.6%, P=0.89), definition 2 (19.9% vs. 15.7%, P=0.43), or either (16.5% vs. 16.3%, P=0.96). The rates of development of bruising, swelling, hematoma, or corporal rupture were not significantly different between the acute and chronic phases under either definition (all P>0.05).Conclusions: This single-center, retrospective cohort analysis suggests that intralesional collagenase is both safe and effective for the treatment of men with acute phase PD. Limitations exist inherent to retrospective review, since many men did not return for post-treatment goniometry, possibly skewing our cohort toward incomplete responders. Prospective, randomized studies will be required to confirm these findings.

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“…According to the current evidence, HA PE treatment improved IELT and was safe and well tolerated, with reported adverse events ranging from 0 to 30% in all research. Localized soreness, protrusion, lump and numbness of the scrotum were the primary adverse effects, which resolved spontaneously in 2 weeks [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

“…Overall, the incidence is between 0 and 30.4%. Among these adverse effects, HA nodules, local discomfort, ecchymosis, papule formation and glans numbness are most common [ 3 , 10 , 15 ]. The possible causes of side effects include the low purity of HA gel, excessive gel injection, the incorrect layer of location, or injection into the blood vessels [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Hyaluronic acid injection to coronal sulcus of the penis for the treatment of premature ejaculation: a retrospective observational study

Chen

et al. 2023

BMC Urol

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Background Hyaluronic acid (HA) injection has become a burgeoning method to treat premature ejaculation (PE) due to its high biocompatibility and structural properties. Purpose In this study, we proposed a modified technique: injecting hyaluronic acid around coronal sulcus to treat PE, aiming to decrease the complications of hyaluronic acid injection in penis while achieving similar effects. Method A total of 85 patients who had HA injection from January 2018 to December 2019 were analyzed retrospectively in our study. 31 patients received injection at glans penis and 54 patients received injection around coronal sulcus. Intravaginal ejaculation latency time (IELT) was mainly measured to estimate the efficacy and the severity of complications was assessed between two groups. Results The mean IELT was 123.0 ± 37.28 s of all patients, 124.7 ± 39.01 s of patients injecting at glans penis and 121.9 ± 36.58 s of patients injecting around coronal sulcus. IELT of all patients increased to 482.1 ± 121.7 s at 1 month, 331.2 ± 81.2 s at 3 month and 280 ± 80.4 s at 6 month. In the group of injecting at glans penis, the incidence of complications is 25.8% and it is 1.9% in the group of injecting around coronal sulcus. No severe complication was reported in both groups. Conclusion The modified technique of injecting around coronal sulcus decreases complications and it has the potential to become a new injectable technique for treating premature ejaculation.

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Clinical use of hyaluronic acid in andrology: A review

Cited by 16 publications

References 58 publications

Effects of One-Shot Hyaluronic Acid Injection in Lifelong Premature Ejaculation: A Pilot Study

Effects of One-Shot Hyaluronic Acid Injection in Lifelong Premature Ejaculation: A Pilot Study

Intralesional collagenase Clostridium histolyticum for acute phase Peyronie’s disease: a single-center, retrospective cohort study

Hyaluronic acid injection to coronal sulcus of the penis for the treatment of premature ejaculation: a retrospective observational study

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