Hyaluronan and the "mushroom" technique: an assessment of hyaluronan injections into the glans.

BACKGROUND An Asian technique of injecting collagen below the corona of the glans-the "mushroom" technique-increases the diameter of the penis glans and heightens sexual sensations for the participant and his sexual partner. OBJECTIVES To improve the physical and aesthetic results of the "mushroom" technique-compared with previous procedures using collagen-by using a new material and alternative injection locations and patterns. MATERIALS AND METHODS The team used a monophasic polydensified hyaluronan (HA) gel for superficial injection into the glans of 12 men aged 28 to 61. Local anesthetic was applied, and one of three injection patterns was tried. Participants self-assessed efficacy and pre- versus postinjection sensitivity using a visual analogue scale and a multiple-choice questionnaire. RESULTS All participants experienced heightened levels of sensation and increased glans diameter. The hyaluronan gel was well tolerated. Of the three injection patterns tested, one (retrograde contiguous injection) was found to be an improvement over the "mushroom" injection protocol. CONCLUSIONS Injection directly into the glans increases its diameter when the penis is erect, and heightens sexual sensations. The monophasic and polydensified hyaluronan gels are suitable alternatives to collagen.