The most effective of all methods known today to increase the size of the penis is its surgical correction.Other methods either do not work (miracle ointments, compresses, nutritional supplements) or give a short-term result (vacuum pump - one-time use, injections - up to 12 months + possibility of side effects).A conservative method is the use of a special device to lengthen the penis, an extender, which exposes the soft tissues of the corpus cavernosum and blood vessels to gradual distension, but must be worn without surgery for a long time (more than six months).
Penile sphincterotomy is a relatively simple phalloplasty operation that allows you to increase the length of a normally functioning reproductive organ.
The surgery consists of releasing the inner part of the shaft of the penis, which is hidden in the subcutaneous fat, by cutting the cartilaginous ligament that attaches it to the pubic bone.The restriction removed in this way makes it possible to lengthen the genital organ by 3-5 cm.After the operation, to prevent fusion of the ligament along the incision line in its previous position, traction devices are used, but for a much shorter period of time than with conservative treatment.
Penile sphincterotomy allows you to change the normal parameters of the penis for life.This has a positive effect on a man's psycho-emotional sphere and his sex life.
It is estimated that a total of 15,414 ligandotomy procedures have been performed worldwide, with almost one in five of all procedures performed in Germany.
This operation is much simpler, safer and cheaper than penile prosthesis, however, when a man, in addition to the small size of the penis, also suffers from severe forms of erectile dysfunction, it can be ineffective.
Clues
Ligamentotomy is only performed in patients who have reached adulthood and may be indicated for health reasons in pathological cases:
- congenital or acquired proliferation of the connective tissue of the penile ligament, which prevents the erection of the penis during erection and makes erection painful (Peyronie's disease).
- replacement of cavernous tissue cells of the penile body with connective tissue cells (cavernous fibrosis).
- micropenis, when most of its axis is hidden in the subcutaneous fatty tissue - the visible part of the erect organ is small in size, which objectively complicates sexual life.
- penile injuries;
- Body dysmorphophobia is a man's obsessive dissatisfaction with the size of the penis (very normal from an anatomical point of view) in the absence of more serious mental illnesses (if the length of the penis at erection is 180 mm or more, the patient may refuse surgical correction).
Men who complain of a small penis despite being of sufficient length usually suffer from either penile dysmorphic disorder (BDD) or small penis anxiety (SPA).In both of these disorders, men consistently underestimate their own penis size and overestimate the average size for other men.
An indication for plastic surgery to increase the length of the male genital organ may be the patient's desire, caused by his aesthetic considerations (in the absence of contraindications), for example, the apparent length of the penis in erection is less than 120 mm.
Preparation
The preparatory process begins with a consultation with a urologist, who will examine the patient, find out the reasons that prompted him to resort to surgical correction and make sure that he does not have diseases of the genitourinary organs.As part of the preoperative examination, the patient undergoes blood tests: clinical, glucose, biochemical composition, coagulation, blood group and Rh factor, presence of syphilis, hepatitis B and C, HIV infection.He will first undergo an X-ray and an electrocardiogram.
The list of studies before surgery can be expanded based on the presence of chronic diseases in the patient.
The patient will talk to the anesthesiologist, be warned that since the operation is done under anesthesia, to avoid suffocation from vomit, he should not eat or drink for the next eight hours.
On the eve of the operation you must shave your pubic hair.
Ligamentotomy technique
The actual surgery involves cutting the superficial cartilaginous ligament that holds the penis in place.This manipulation allows you to pull the penis out of the uterus without violating its anatomical integrity.
The operation is performed openly through an incision, which is often made in the scrotal area (in the midline) or in the lower part of the pubis, when the greatest release of the hidden part of the shaft of the penis is required.Usually, the approach is discussed before the operation and determined according to the solution of the problem.
Modern operating rooms are often equipped with endoscopic equipment, so microincisions are made.
The classic method consists in cutting the ligament and stretching the penis to a certain length up to 25-50 mm (depending on the length of the hidden part of the shaft).Stapling and fixation of the longitudinal organ using a stretcher.
A more modern method involves the use of the patient's fat, which is taken from the places where it accumulates during the operation.The fat is placed in the cavity of the anatomical joint (lipofilling), which promotes tissue healing and prevents adhesions.After that a suture is applied.The second type of intervention takes a little longer.
Complete release of the corpora cavernosa from the pubic root is associated with a significant risk of severing the penile neurovascular bundles, causing penile denervation and devascularization.
The operation itself takes about 30-60 minutes, the patient remains in the clinic for a day, however, its success is facilitated by proper postoperative care, which is the second and necessary stage of penis lengthening.
Contraindications for the conduct
The possibility of performing the operation is not considered until the patient turns 18 years old.
He should not have mental illness, bleeding tendency, genitourinary diseases, malignant tumors or diabetes.
The operation is not performed during periods of acute infectious diseases in the patient and/or exacerbation of chronic conditions.
Consequences after the procedure
After the ligature, the functions of the genital organ (urination and erection) are usually fully preserved.the muscle tissue, ligaments and vessels responsible for these functions are not affected during the operation.Lymphatic drainage during conjunctotomy should not be disturbed, as the lymphatic vessels should not be damaged if the operation is performed correctly.However, slight swelling in the surgical area is possible, as is bruising.Access through the scrotum is more tolerable, the suture heals faster, but the incision in the pubic region is more often complicated by hematomas and swelling.
The result of the use of general anesthesia is drowsiness, and impaired coordination of attention usually disappears within 24 hours, even in the most sensitive patients.
Complications after the procedure
Surprisingly, the main side effects of this procedure are relapse, penile shortening and lack of penile support during erection, leading to difficulty in intercourse and penetration.
Complications after the procedure are definitely possible.However, this is an operation.If unwanted consequences occur, you should consult a doctor for advice on taking the necessary measures.
Sealing of a suture after a ligamentotomy is a normal process.The scar that forms is always thick.later softens.The stitches heal in about three weeks.For some it is earlier, for others it is later.
Leakage of sutures indicates a bacterial infection and it is not at all necessary to "introduce infection during the operation".Perhaps the patient had a chronic infectious process.The infection is usually treated with antibacterial drugs.To prescribe them you must consult a doctor.
Plaques should not appear after ligamentotomy.These, which cause penile curvature and pain, are surgically removed during this operation.This is the proliferation of fibrous tissue in the tunica albuginea of the corpora cavernosa.The main reason for their appearance is said to be microtrauma to the penis (usually during sexual intercourse) with the development of microbleeds, in the place of which areas of connective tissue are then formed.If plaques appear again, you should, firstly, see a doctor, and secondly, think with your doctor about what is causing them to appear.
A scar may well appear after a syndesmotomy, as post-operative scars form during any operation.Over time they become softer and separate.Much depends on the quality of the patient's skin and the skill of the surgeon.Physiotherapy and other methods are used to resolve post-surgical scars.If the scar bothers you a lot, you can consult a doctor about it.
Post-procedure care
In the postoperative period, analgesics may be prescribed to relieve pain.Bandages are applied every 2-3 days, sutures are usually removed 14 days after surgery.It is recommended to avoid sexual contact for 1-1.5 months.
A mandatory postoperative stage for any type of operation is to wear a stretcher first (for the first three weeks, sometimes for a longer period) and then an extension.Without it, the operation may not make sense, since the ligament will heal along the line of the tear and the penis will return to its original position.In addition, stretching the genital organ allows you to lengthen it by an additional 15-25 mm.
The minimum period to wear an extension is two months.On postoperative days it is worn for only one to two hours, later it is worn for six to eight hours each day.Be sure to take it off at night.
The joint heals under the influence of the stretcher, but not along the cut line, but in a stretched position.The presence of the patient's own fat in the incision cavity promotes rapid tissue granulation.
You need to stretch the penis gradually, carefully, avoiding pain, strictly following the doctor's recommendations.Only a slight tension should be felt.
Reviews
Reviews about the function are different.Some complain of complications, hematomas and fever.Basically, such complaints are typical in the early postoperative period and should be addressed to a doctor.Each body is individual and stitches take at least 10-14 days to heal.
The results of ligamentotomy were not always favorable.Patient and partner satisfaction levels range from 30 to 65%.On average, the operation increases the resting length of the penis by 1-3 cm.Low satisfaction rates make this surgical technique unfavorable for many patients.
In addition, questions are often asked whether it is possible to lengthen the penis and increase its thickness at the same time.This is not recommended.Experts recommend first to perform a conjunctotomy, and only after stopping all measures to stretch the penis in length using an extension that squeezes the organ tightly, which is unacceptable to do after the penis has increased in thickness, you can proceed to the next stage.