MALE GENITAL SURGERY

The concern of men regarding penis size has been constant throughout history. In some African cultures it was customary to use stones tied to the penis with the aim of achieving an increase in length. In Eastern countries such as Korea penile size is associated with youth and strength, however the retraction is associated with aging and loss of sexual potency.

Today there has been an increase in our society in medical consultations demanding methods to help achieve increased penis size in both width and length.

This attitude has been fuelled by widespread habits and customs that are now minor or non-existent. Out of all of these we firstly include the increase and diversity of media disclosures of pornography, the proliferation of nudist beaches and less noble behaviour in the locker rooms of sports facilities. This coupled with the “congenital” obsession that man has always had with the size of his penis, has led the search for “solutions” to this problem.

The most evident manifestation of the opposite is the great variety of objects or gadgets that we can find published in press, TV and internet, not to mention the battery of chemical products with the same objectives.

Within this list of tips to get improvement in the size of the male sexual organ the most significant, is surgery. But even if surgery is considered minor surgery, it involves knowing its capabilities and its consequences, namely, that we can offer and, in particular, that undesirable effects may occur.

We won´t talk about chemicals or pharmaceuticals since they are nonexistent in the Handbook approved by health authorities.

With respect to devices which operate by continuous traction, its intended effects only occur when the drive mechanism remains almost constantly, as is the case of the examples from giraffe women or loosening of the skin during pregnancy.

In both cases the mechanisms that cause bloating act 24 hours a day. However, what the majority of surgeons that practice penile interventions agree on in their conference papers or medical supplies, is that these gadgets are useful and recommended as a complementary method to surgery, since the release of the penis after the suspensory ligaments section so they are recommended for use to be consolidated in this new situation, working to get even a centimetre more of elongation.

Who is a candidate for penis enlargement?

We know that virtually all those seeking to increase the length of their penis do NOT have any sexual problem, or of erection or ejaculation, so choosing good candidates for this surgery is elementary.

It is indicated for:

  • Penises less than 6 inches in flaccid state
  • Patients who have been amputee a portion of the penis, usually for cancer.
  • Patients with penile curvature, either congenital or acquired (Peyronie disease)
  • Obese patients whose fat has “buried” in part to the penis.
  • In cases where behaviours are conditioned by a complex of small penis

Description of surgical technique

Release of the suspensory ligament of the penis

Looking at a picture of anatomy observe how the penis has two portions, one we can see, called “extra-abdominal penis”, and another that we do not see because it is inside our body called “intra-abdominal penis. When compared to an iceberg, the visible penis would correspond to extra-abdominal and the submerged in water to intra-abdominal penis (although in this instance the proportions are not the same).

Intra-and extra-abdominal penis

Well since the surgery aims to externalize part of the penis that is not visible, or “draw” out of the abdomen part of the penis we do not see.

How is this achieved?

Dorsal penile elongation

  • Release of suspensory ligament of the penis
  •  Liberation of the fundiform ligaments

The penis has ligaments that keep it (somewhat) fixed to their neighboring structures. There are three ligaments, two bundles determined by the fascia of Scarpa, known as “fundiform ligament” and one, the most important and determining called suspensory ligament or suprapubic ligament. Consisting of a thick sheet comprising a triangular-shaped line stretching from the dawn to the dorsal midline of the penis. This ligament is embryonic remnant of a most developed ligament that kept the penis held against the abdomen when the man walked with his feet and hands.

Suprapubic ligament surgery for dorsal elongation, is, as we have said, “pull” part of the penis outside the abdomen, this will release the penis of the pinching to which it is subjected by the suspensory ligament and the fundiform in the “fixed part of penis”. Once the fixed part of the penis is released, it allows us to externalize a few inches of intra-abdominal penis, thereby increasing the visual and functional length of the penis.

Once this surgical step is finished the penis is fixed in its new position with the intention of avoiding the retraction.

How much length can we increase?

Of course that in all cases we intend to achieve the greatest possible number of inches, but our desires are conditioned by the anatomy of each individual. The increase in length is attached to the possibilities the suspensory ligament offers us, so that in cases in which we find a relaxed ligament, the result is lower than in cases where the ligament has further subjection. In any case the length achieved is usually between 15 and 30 mm, a figure that may increase slightly if after surgery one of the elongation gadgets based on continuous traction of the penis is used for a couple of months. We recommend the use of the Jes extender for easy handling and results. This device helps to not only to increase the length achieved with the intervention, but is involved in building it. We encourage its use gradually starting at 15 days after surgery and continue to use the Jes Extender for a few months to achieve the stability of the milestone reached.

What complications or side effects may occur?

The fact is that in even the most humble surgery unwanted side effects may occur, therefore this one is no exception.

Although in our experience we have had no issues of concern, if we must mention a few minor inconveniences experienced and others, without having had, may appear. A passing disorder that appears is pain with nocturnal erections, such nuisance usually disappears once the tissues are done healing. The partial and temporary loss of sensation in the glands is an aspect that some people operated on have told. This sensitivity is usually recovered as nervous filaments affected during surgery are regenerated. The subcutaneous bruising is fairly common, but often lacks relevance and disappears within a few days. We have not experienced any infections, but if you have a wound they may appear. We suggest a few days with antibiotic treatment. But the most important complication for me, is an outcome that doesn´t meets the expectations of the patient. In the cases in which we achieve a significative increase the satisfaction is shared.

We have not suffered any significant side effect and the average elongation achieved was 1 to 3.5 cm, With an average of 2.5. Some patients have achieved an added increase of 1 to 2 inches using a continuous traction element like the Andro-penis type.

What anesthesia is necessary?

This surgery is usually performed under regional anaesthesia (lower abdomen and lower extremities).

Could be done with local anaesthesia plus sedation, although it doesn´t bring great benefits.

Must i remain hospitalized?

It is not necessary to remain in the clinic. Once the intervention is done, you will be taken to the area denominated “day hospital” one or three hours until the effects of the aesthesia have disappeared, to then be discharged.

Incision and postoperative care

To carry out a penis enlargement we need to make an incision about 3 cm at the base of the penis and use an absorbable suture, which does not need stitches after the wound healed. Wound care is advised once every 24 hours while maintaining the points.

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