Penile augmentation by division of the suspensory ligament of the penis and autologous fat injection

Abstract

To evaluate the outcome of penile augmentation (PA) surgery at one center. A retrospective review of 471 patients who underwent division of the suspensory ligament of the penis, with insertion of silicon buffer, and autologous fat injection at one unit. The following data were collected: the penile length and girth before and after the surgery, patient satisfaction and the complication rate. 471 patients were included this review over a 4 year period. The mean patient age was 35 (26-62) years; mean follow-up period was 4 (1-9) months; mean pre-operative flaccid length and girth was 9.4 (6-14) cm and 8.9 (7-11.5) cm respectively; and the mean increase in flaccid penile length and girth was 4.2 (2-8) cm and 3.9 (2.5- 7.5) cm respectively. In terms of patient-reported treatment outcome: 80% of the patients satisfied with the procedure, the main source of the dissatisfaction in the remaining patients was fat loss which occured in 94 (20%) patients and was managed by fat top up. No serious complications were encountered: 15 patients developed phimosis which resolved spontaneously except in 2 patients who needed a circumcision; 8 patients experienced the formation of a hard fat lump which was managed by needling and hyalase injections in an outpatient setting; 5 patients experienced infection of the silicon buffer which required surgical removal; 3 patients experienced discomfort from the silicon buffer which required surgical removal;7 patients had migration of some fat into the scrotum and 3 of them required surgical removal of the fat lump. None of the patients complained of downward angulation of the penis, sensory changes or erectile dysfunction. Surgical Penile enlargement is a safe, effective procedure associated with a high patient-satisfaction rates. None