The most effective among all currently known methods for increasing the size of the penis is its surgical correction.Other methods either do not work (miracle ointments, compresses, dietary supplements) or give a short-term effect (vacuum pump - one time use, injections - up to 12 months + the possibility of side effects).A conservative method is the use of a special device for lengthening the penis, an extender, which exposes the soft tissues of the corpus cavernosum and blood vessels in gradual extension, but must be kept 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 freeing the inner part of the shaft of the penis, hidden in the subcutaneous fat, by cutting the cartilage-like ligament that fixes it to the pubic bone.The restriction removed in this way makes it possible to extend the genital organ by 3-5 cm.After surgery, 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.
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 are performed worldwide, with almost one in five of all procedures performed in Germany.
This operation is much simpler, safer and cheaper than the penis 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.
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, which prevents the erection of the penis and makes erection painful (Peyronie's disease);
- replacement of cells of the cavernous tissue of the body of the penis with cells of connective tissue (cavernous fibrosis);
- micropenis, when most of its shaft is hidden in subcutaneous fatty tissue - the visible part of the erectile 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 (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 denied surgical correction).
Men who complain of a small penis despite being of sufficient length usually suffer from penile dysmorphic disorder (BDD) or small penis anxiety (SPA).In both of these disorders, men consistently underestimate the size of their own penis 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 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 led 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 fluorography and electrocardiography.
The list of preoperative studies can be expanded based on the presence of chronic diseases in the patient.
The patient will talk to the anesthesiologist, he 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 current surgical intervention consists of cutting the superficial cartilaginous ligament that holds the penis in a certain position.This manipulation allows you to extract the penis from under the abdomen without violating its anatomical integrity.
The operation is performed openly through an incision, which is often made in the area of the scrotum (in the middle line) or in the lower part of the pubis, when the greatest release of the hidden part of the shaft of the penis is required.Typically, 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 micro-incisions are made.
The classic method consists in cutting the ligament and stretching the penis to a certain length of up to 25-50 mm (depending on the length of the hidden part of the shaft).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 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 ramus is associated with a significant risk of disruption of the neurovascular bundles of the penis, causing denervation and devascularization of the penis.
The operation itself lasts about 30-60 minutes, the patient stays in the clinic for a day, however, its success is facilitated by proper postoperative care, which is the second and necessary stage of penis enlargement.
Contraindications for performance
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 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;muscle tissues, ligaments and vessels responsible for these functions are not affected during the operation.Lymphatic drainage during ligamentotomy 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 easier to tolerate, the suture heals faster, but the incision in the pubis is more often complicated by hematoma 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
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 after the procedure are certainly possible.However, this is an operation.If unwanted consequences appear, you should consult a doctor for advice on taking the necessary measures.
Closure of sutures after ligamentotomy is a normal process.The formation sign is always dense;later softens.Stitches heal in about three weeks.For some it is earlier, for others it is later.
Bursting of the stitches 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 should consult a doctor.
Plaques should not appear after ligamentotomy.Those, which cause the curvature of the penis and its pain, are surgically eliminated 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 of the penis (usually during sexual intercourse) with the development of microhemorrhages, instead of which areas of connective tissue are formed.If the plaques appear again, you should first go to the doctor, and secondly, think with your doctor about what causes them to appear.
A scar may well appear after a ligamentotomy, as postoperative scars are formed 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 wounds after surgery.If the scar bothers you a lot, you can consult a doctor about it.
Care after the procedure
In the postoperative period, analgesics may be prescribed to relieve pain.Dressings are done every 2-3 days, stitches 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 first wear a stretcher (the first three weeks, sometimes for a longer time), then an extender;without this, the operation may be meaningless, since the ligament will heal along the rupture line and the penis will return to its original position.In addition, the extension of the genital organ allows you to extend it by an additional 15-25 mm.
The minimum period to wear an extender is two months.In the days after the operation, it is worn for only one to two hours, later it is worn for six to eight hours every day.Make sure to remove it at night.
The ligament heals under the influence of the stretcher, but not along the cut line, but in a lying position.The presence of the patient's own fat in the incision cavity promotes rapid tissue granulation.
You should lengthen the penis gradually, carefully, avoiding pain, strictly following the doctor's recommendations.Only a slight tension should be felt.
evaluations
Reviews about the operation are different.Some complain of complications, hematoma and fever.Basically, such complaints are typical in the early postoperative period and should be addressed to the doctor.Each body is individual, and stitches need 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.The low satisfaction rate makes 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 performing a ligamentotomy and, only after stopping all measures to stretch the penis in length using an extender that tightly tightens the organ, which is unacceptable to do after the thickness of the penis has increased, you can proceed to the next stage.