(342) Glans Augmentation and Glans – Bulbospongiousus Reflex

Abstract Introduction The creation of a barrier at the level of glans by the bulking agents blocking accessibility and inhibiting the tactile stimuli to reach the dorsal nerve of penis (branch of pudendal nerve) receptors is the theory behind the effect of hyaluronic acid in the field of premature ejaculation. Clinically there is a doubt about that as filler injection in frenular delta (most sensitive area in penis) and in G-spot at female accelerates time of ejaculation, some cases with history of failed dorsal neurectomy my response to hyaluronic acid injection, filler or fat injection in penis shaft doesn’t improve ejaculation time, in the opposite side implants like Elist`s implant (pneuoma) or other solid inner condoms improves premature ejaculations. The cause is that the hard implant masks pressure on the corona thus inhibits glans – bulbospongiosus reflex which delays the second phase of ejaculation, ring application at coronal sulcus delays ejaculation for the same reason, filler or fat is not solid and doesn’t resist pressure and compressed due to pressure. In glans area compression is not possible due to tight space at glans mucosa. Objective Explanation why glans augmentation by filler delays ejaculation. Methods Seven patients with history of previous glans penis augmentation (hyaluronic acid) with good response (12-14 months ago) instead of re-injection, Alaa Aglan operation was done, cutting of bulbospongiosus muscles bilaterally plus frenular delta excision 4 months post-operative all patients were injected by hyaluronic acid at glans. Results All patients were satisfied by the operation, 3 months post-operative the gained time was calculated for each patient (by himself) then hyaluronic acid injection was done. No change in time was reported in all patients and they reported that it was still the same time gained after surgery despite all patients reported satisfactory results after previous injection one year ago. Conclusions Inhibition of glans – bulbospongiosus reflex is the main cause to delay ejaculation after glans augmentation. Disclosure No.