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Randomized Controlled Trial
. 2025 May 21;15(1):17575.
doi: 10.1038/s41598-025-02466-1.

Hyaluronic acid versus botulinum a toxin injection in the treatment of premature ejaculation: A comparative study

Mohamed S Hasan  1 , AbdRaouf M Almohsen  1 , Ibrahim Mearaj  1 , Maged T Abd Elsalam  2 , Mohamed L Elsaie  3
Affiliations
Randomized Controlled Trial

Hyaluronic acid versus botulinum a toxin injection in the treatment of premature ejaculation: A comparative study

Mohamed S Hasan et al. Sci Rep. .

Abstract

The aim of the study was to assess safety and efficacy of botulinum-A toxin (BTX) injection into the bulbospongiosus muscle versus hyaluronic acid (HA) gel injection in glans penis for treatment of premature ejaculation (PE). The patients were randomly divided into 2 groups. Group a (n = 30) were injected with botulinum toxin type a injection in bulbospongiosus (BS) muscle at the perineum (25 units on each side). Group b (n = 30) were injected with 2 ml hyaluronic acid along the corona (proximal part) of the glans penis and frenulum. The mean IELT significantly increased from 1.78 min to 3.87 min after the BTX injection while the mean IELT was significantly increased to 7.3 min from 1.23 min before injection among the hyaluronic acid injected group (p < 0.001). The improvement of IELT was more significantly noted in the HA group than BTX group by the end of treatment. Both modalities provided a well- tolerated potential treatment in the management of PE with, HA demonstrating a higher efficacy than BTX. More high-quality, randomized prospective studies and the standardization of the inclusion criteria and the outcome assessment methods are needed in order to confirm these findings.

Keywords: Botulinum toxin; Hyaluronic acid; Premature ejaculation; Sex.

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Conflict of interest statement

Declarations. Competing interests: The authors declare no competing interests. Ethics approval: This study protocol was reviewed and approved by ethics committee on human research by Al Azhar faculty of medicine (DerMed 117). All methods were performed in accordance with the relevant guidelines and regulations. Consent to participate: Written informed consents were received from participants or their guardians upon explanation of the study.

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