One-stage Circumcision and Hyaluronic acid injections for Men Reporting Small Penis with Redundant Prepuce or Phimosis

Abstract

Abstract Background The efficacy and safety of filler injection were approved and have become the main choice for penile augmentation (PA). Traditionally, the PA for patients with phimosis or redundant prepuce has been a two-stage surgery-male circumcision first and hyaluronic acid (HA) injections then. We introduced a one-stage procedure for these patients to reduce the cost and recovery time.Methods Eighty-three men who received one-stage male circumcision and HA injection simultaneously in a regional hospital from January 2018 to December 2019 were retrospectively reviewed. In the male circumcision, the penile skin was sharply resected to preserve the integrity of the superficial fascia. HA was injected into the space between the superficial fascia and the deep fascia of the penis. Patients were followed up at 3 months, 6 months, and 12 months after the surgery. Penile maximal girth, patients’ satisfaction level for (using a 5-point scale, with 1 indicating very dissatisfied and 5 indicating very satisfied.) penile appearance and surgical complications were recorded during follow-up.Results Eighty-three men (aged 35.72 ± 4.73 years) received one-stage male circumcision and HA injection surgery. The dosage of HA was 16.10 ± 2.32 ml. The penile maximal girth growth was 2.33 ± 1.27 cm, 1.80 ± 1.11 cm, and 1.31 ± 0.71 cm at the 3-month, 6-month, and 12-month follow-ups, respectively. The satisfaction level for penile appearance was 2.5 ± 0.9 on the final follow-up The complications included 1 (1.2%) infection and 1 subcutaneous bleeding (1.2%). No HA leakage happened.Conclusion One-stage simultaneous male circumcision and HA injection were proven to ensure surgical efficacy and safety for men reporting a small penis with redundant prepuce or phimosis.