The efficacy of hyaluronic acid in treating premature ejaculation: A systematic review and single-armed meta-analysis

Aim: To evaluate the efficacy of hyaluronic acid (HA) injection in treating patients with premature ejaculation (PE). Methods: Matching interventional studies from MEDLINE, CENTRAL, and CINAHL. Outcomes were intravaginal estimated latency time (IELT), glandular circumference, satisfaction score, and adverse event rate. Data were assessed with Open Meta Analyst, DerSimonian and Laird random-effects model. Results: Ten interventional studies, three double-armed, with low to moderate bias risk, revealed significant differences in baseline IELT and 1, 3, and 6-month post-hyaluronic acid injection, with mean differences of 217.035 (95% CI, 89.330-344.739), 161.513 (95% CI, 37.262-285.764), and 196.350 (95% CI, 142.314-250.386) seconds. Glandular circumference increased by 10.956 mm (95% CI, 3.314-18.598) after six months. Conclusion: Hyaluronic acid successfully extended IELT in premature ejaculation patients at one, three, and six months post -treatment with no severe side effects. It also enhanced glandular size and sexual satisfaction for patients and their partners.