The most effective among all known methods 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 effect (vacuum pump - single use, injections - up to 12 months + possibility of side effects).A conservative method is the use of a special device for lengthening the penis, an extender that exposes the soft tissues of the corpus cavernosum and blood vessels to gradual stretching, but it must be worn without surgery for a long period of time (more than six months).
Ligamentotomy of the penis is a relatively simple phalloplasty operation that allows you to increase the length of a normally functioning reproductive organ.
The surgical intervention consists in releasing the inner part of the shaft of the penis, hidden in the subcutaneous fat, by cutting the cartilaginous ligament that fixes 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, in order to prevent the fusion of the ligament along the incision line to its previous position, traction devices are used, but for a much shorter period of time than with conservative treatment.
Ligamentotomy of the penis allows you to change the physiological 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 ligamentotomy procedures were performed worldwide, with almost one in five of all procedures performed in Germany.
This operation is much simpler, safer and cheaper than penile prosthesis, but when the man, in addition to the small size of the penis, also suffers from severe forms of erectile dysfunction, it can be ineffective.
Indications
Ligamentotomy is performed only in patients who have reached the age of majority, and may be indicated for health reasons in pathological cases:
- congenital or acquired proliferation of the connective tissue of the penile ligament that prevents the erect penis from erecting and makes erection painful (Peyronie's disease);
- replacement of the cells of the cavernous tissue of the body of the penis with cells of the connective tissue (cavernous fibrosis);
- micropenis, when most of its body is hidden in the subcutaneous fatty tissue - the visible part of the erect organ is small in size, which objectively complicates sex life;
- penile injuries;
- body dysmorphophobia is a man's obsessive dissatisfaction with the size of the penis (quite normal from an anatomical point of view) in the absence of more serious mental illnesses (if the length of the erect penis is 180 mm or more, the patient may be refused 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 disorders, men consistently underestimate their 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 visible length of the erect penis 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 there are no 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.First, he will undergo fluorography and electrocardiography.
The list of tests before surgery can be expanded based on the presence of chronic diseases in the patient.
The patient will talk to the anesthetist, will be warned that since the operation is performed under anesthesia to avoid asphyxiation from vomiting, he should not eat or drink for the next eight hours.
On the eve of the operation, you should shave your pubic hair.
Ligamentotomy technique
The actual surgical intervention consists of cutting the superficial cartilaginous ligament that holds the penis in a certain position.This manipulation allows you to pull the penis from under the womb without disturbing its anatomical integrity.
The operation is performed openly through an incision, which is often made in the area of the scrotum (on the midline) or in the lower part of the pubis, when the greatest release of the hidden part of the body of the penis is needed.Usually, the approach is discussed before the operation and is determined depending on the solution of the problem.
Modern operating rooms are often equipped with endoscopic equipment, in which case microincisions are made.
The classic method consists of cutting the ligament and stretching the penis to a certain length of 25-50 mm (depending on the length of the hidden part of the body).Suturing and fixation of the elongated 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.Fat is placed in the cavity of the dissected ligament (lipofilling), which promotes tissue healing and prevents the formation of adhesions.After which a stitch is applied.The second type of intervention takes a little longer.
Complete release of the corpora cavernosa from the pubic muscle is associated with a significant risk of disruption of the penile neurovascular bundles, causing penile denervation and devascularization.
The operation itself lasts about 30-60 minutes, the patient remains in the clinic for a day, but its success is facilitated by proper postoperative care, which is the second and necessary stage of penis enlargement.
Contraindications for conducting
The possibility of performing the operation is not considered until the patient reaches 18 years of age.
There should be no mental illness, bleeding tendency, genitourinary disease, malignant tumors or diabetes.
The operation is not performed during periods of acute infectious diseases in the patient and/or exacerbation of chronic ones.
Consequences after the procedure
After ligamentotomy, the functions of the genital organ (urination and erection) are usually completely preserved;the muscle tissue, ligaments and vessels responsible for these functions are not affected during the operation.Lymphatic drainage during ligamentotomy should not be disturbed, as lymphatic vessels should not be damaged if the operation is performed correctly.However, slight swelling in the area of the operation is possible, as well as bruising.Access through the scrotum is easier to tolerate, the suture heals faster, but the pubic incision is more often complicated by hematomas and swelling.
The result of the use of general anesthesia is drowsiness and impaired coordination of attention usually disappear within 24 hours, even in the most sensitive patients.
Complications after the procedure
Paradoxically, the main side effects of this procedure are relapse, shortening of the penis and lack of support for the penis during erection, leading to difficulties in intercourse and penetration.
Complications are certainly possible after the procedure.It's an operation after all.If unwanted consequences occur, you should consult a doctor for advice on taking the necessary measures.
Sealing the suture after a ligamentotomy is a normal process.The resulting scar is always dense;later softens.Sutures heal in about three weeks.For some earlier, for others later.
Suppuration of the sutures indicates a bacterial infection, and it is not at all necessary that "an infection was introduced 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.Those that 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.Microtrauma to the penis (usually during sexual intercourse) with the development of microhemorrhages is considered the main cause of their appearance, in the place of which areas of connective tissue are then formed.If the plaques reappear, you should, firstly, see a doctor and secondly, think with your doctor about what is causing them to appear.
A scar may appear after a ligamentotomy, 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 remove postoperative scars.If the scar bothers you a lot, you can consult a doctor about it.
Post-procedural care
In the postoperative period, analgesics may be prescribed to relieve pain.Dressings are made every 2-3 days, sutures are usually removed 14 days after the operation.It is recommended to avoid sexual contact for 1-1.5 months.
Mandatory postoperative stage in any type of operation is first wearing a stretcher (the first three weeks, sometimes for a longer time), then an extender;otherwise, the operation may be pointless, as the ligament will heal along the tear line 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 for wearing an extender is two months.On postoperative days it is worn for only one to two hours, later it is worn for six to eight hours every day.Don't forget to take it off at night.
The ligament heals under the influence of the extensor, but not along the line of the incision, but in a stretched position.The presence of the patient's own fat in the incision cavity promotes rapid tissue granulation.
You should stretch the penis gradually, carefully, avoiding pain, strictly following the doctor's recommendations.Only a slight tension should be felt.
Reviews
Reviews about the operation are different.Some complain of complications, hematomas and fever.In general, such complaints are characteristic of the early postoperative period and should be addressed to a doctor.Each organism is individual and stitches need at least 10-14 days to heal.
Ligamentotomy results are not always favorable.Patient and partner satisfaction levels ranged from 30 to 65%.On average, the operation increases the length of the penis at rest 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 performing a ligamentotomy first, and only after stopping all measures to stretch the penis in length with the help of an extender that tightly tightens the organ, which is unacceptable to do after increasing the thickness of the penis, you can proceed to the next stage.