(158) Comparison Implants for Penile Girth Enlargement: PPLA Shaft vs Silicone Implant

Abstract

Abstract Introduction Male dissatisfaction with the penis size is the most common manifestation of penile dysmorphophobia. Despite the diversity of penis enlargement methods a single safe technique that fully satisfies patients has not yet been developed. Objective The aim of this work is to compare the results of a combined operation on installation of a silicone implant or a porous polylactic acid (PPLA) scaffold impregnated with autologous stem cells with simultaneous ligamenotaxis to increase the length and circumference of the penis. Methods In 2017–2023 there were performed penis enlargement surgeries in 3 centers. In Ukraine and Poland 38 patients from were operated with implantation of a porous Max Pol PLLA scaffold, and in Mexico implantation of silicone implants Peniflex in 36 patients was performed. The results of penis enlargement were evaluated in the early (2 months) and long-term (36 months) periods. Results While implanting a silicone implant the majority of the patients - 31 (86.1%) are satisfied with the result, 27 (75%) patients mention an improvement in sexual life, 31 (86.1%) also mention an increase in their own self-sufficiency. At the same time, some patients mentioned the following complications: 2 (5.6%) patients mentioned displacement of the silicone matrix, 1 (2.8%) patient mentioned prolapse of the implant, 1 (2.8%) patient mentioned a decrease in erection (which did not improve after removal of the implant), in 1 (2.8%) case the silicone implant had to be removed due to the fact that the patient did not liked the appearance. While using a collagen-like matrix made of polymerized polylactic acid impregnated with autological stem cells in 38 patients, we have seen one significant complication - prolapse that caused the removal of the matrix (in men that had denied circumcision before implantation). However, 5 (13.2%) patients required additional polylactic acid gel injections between 6 and 36 months to optimize the shape or volume of the penis. 34 (89.5%) patients mentioned an improvement in the sexual function and sexual sensations of their partner, harmonization of relationships in a couple, and 36 (97.4%) men - an increase in a sense of self-sufficiency. In 3 years most of the patients 26 (68,4%) have been satisfied with particularly resolved implant but 13 (34.2) patients want to add some PLA gel as injection for penile girth recovery. Conclusions Thus, modern implants can improve the size and appearance of the penis, improve the quality of sexual life and the feeling of self-sufficiency in operated men. The use of silicone implants is simpler, it require only long drain 3–5 days. Most of operated patients were satisfied results of silicone implant. The use of a polymer matrix impregnated with autologuous stem cells requires a special biostem cell laboratory, more time for preoperative rehabilitation, but can be considered as more philological. Both methods can be considered as permanent and quite safe for penis enlargement. Disclosure No.