Traditional multipuncture technique versus atraumatic cannula technique for hyaluronic acid penile girth enlargement: a retrospective cohort study

Abstract Objective To compare the traditional multipuncture technique (TMT) and the atraumatic cannula technique (ACT) for the penile girth enlargement (PGE) procedure using hyaluronic acid (HA). Methods Patients who underwent PGE with HA fillers between January 2022 and May 2025 were enrolled into the study. Patients’ preoperative characteristics were recorded. Thickness increase, IIEF score, patient satisfaction scores according to Likert scale were noted 3 months, 6 months and 1 year after the procedure. Also, complications were saved. Preoperative data of participants, operative parameters, post-operative thickness increase, patient satisfaction, and complications of two groups were compared in detail. Results In total, 280 cases in the ACT group and 178 cases in the TMT group completed the one-year follow-up schedule. The increases in thickness were not significantly different between the ACT group and TMT group at 3rd month, 6th month and 1st year follow-ups (p = 0.205, p = 0.285, and p = 0.746). Patient satisfaction according to the Likert scale was 4.5 for the ACT group and 3.3 for the TMT group, and the difference was significantly better in favour of the ACT group (p = 0.001) at first-year follow-up. Hematoma was observed in 5 (1.78%) patients in the ACT group and 11 (6.18%) patients in the TMT group (p = 0.001), and nodules were seen in 4 (1.42%) patients in the ACT group and 12 (6.74%) patients in the TMT group (p = 0.001), respectively. Migration was diagnosed in 3 (1.07%) patients in the ACT group and 15 (8.42%) patients in the TMT group (p = 0.001). Conclusion Present study findings demonstrated that TMT and ACT achieved similar success rates for PGE. However, patient visual satisfaction was significantly better, and complications were detected in significantly fewer numbers in favour of ACT.