LAUSR

BACKGROUND In recent years aesthetic injection techniques using soft tissue fillers are becoming popular worldwide due to their effectiveness, safety, and low cost. There is no standard approach for the management and follow-up of patients seeking penile enlargement procedures described in the literature and the surgical penile enlargement methods are also controversial. OBJECTIVES To assess the effect of injection penile girth enlargement on sexual relationship satisfaction, confidence, self-esteem, and to evaluate the clinical efficacy and safety of this procedure for the management of men with small penis syndrome (SPS). METHODS This is a single-center, clinical case series study executed from January 2019 to February 2021, that involved 148 men who were unsatisfied with the shape of their normal-sized penises and requested penis girth correction. RESULTS A total of 132 patients completed full treatment and follow-up. Mean girth enlargement was 1.7 ± 0.32 cm for the mid-shaft and 1.5 ± 0.32 cm for the glans of the penis. Satisfaction with sexual life improved. Mean scores increased by 17.9 ± 3.04 points for the sexual relationship and by 12.2 ± 3.17 points for the confidence. The self-esteem mean score raised by 8 ± 2.8 and by 4.3 ± 0.97 points for the overall relationship. CONCLUSIONS Penile enlargement with hyaluronic acid (HA) injection positively affects sexual relationship satisfaction, confidence, and self-esteem of men with SPS. But the rate of psychosocial improvement does not correlate with penile size changes. It is a simple, safe, and effective technique that can be used in daily clinical practice.