Penile Girth Enhancement Research Articles

(129) Penile Girth Enhancement Using UroFill™: The Brazilian Experience

Abstract Introduction Demands for penile girth enhancement are increasing. UroFill™ is the innovative approach that offers non-surgical and reproducible penile girth enhancement. Objective To demonstrate the penile girth before and after the application of hyaluronic acid with the UroFill™ technique Methods A retrospective, single-center study included men who sought private care to realize penile girth enhancement using UroFill™ technique from April to June 2023. All patients signed an informed consent form. Excluded men with dysmorphophobia, active inflammatory-infectious genital lesion, and prior application of another filler. Penile girth was measured with a tape measure at baseline and after 21 days. Results 21 patients were included in this analysis. Mean injected volume was 5.81ml. Compared a mean with a basal girth of 9.11±1.1cm and after 1 application 10.85±0.9cm and the Test t result was significant p < 0.001. There were no inflammatory signs or serious adverse reactions in all cases, and no patient requested a reversal of the procedure. Conclusions This study demonstrates the increase in penile girth after just one application of hyaluronic acid using the Urofill technique. In addition, we did not find any cases of complications in the evaluated patients, which suggests a safe procedure. Disclosure No.

(019) Penile Augmentation by Division of the Suspensory Ligament of the Penis and Autologous Fat Injection

Abstract Introduction Penile size dissatisfaction is a problem which is more prevalent than what is perceived, it is not taken seriously by healthcare professionals. It is reported that 45% of men are unhappy with their penile size. Most men are too ashamed to seek professional help so they go to online sites that promote fake pills, creams, lotions, or try to solve the problem themselves (DIY Penile enlargement) which causes significant complications or undergo high risk procedures without proper counselling. Objective The aim of this study was to evaluate the outcome of penile augmentation surgery by division of the suspensory ligament of the penis with insertion of silicon buffer for flaccid length enhancement plus liposuction and autologous fat injection for penile girth enhancement. Methods A retrospective audit of patient outcomes after surgical Penile Augmentation (PA) at one centre, over a 5.5 year period. 560 patients had division of the suspensory ligament of the penis with insertion of silicon buffer with liposuction and autologous fat injection. The following data was collected: - Pre and post-operative flaccid penile length and girth. - Patient reported satisfaction rates. - Complications. Results 560 patients were included in this study, the mean patient age was 38 (24–72). The Mean follow up duration was 6 (3-12) months. The mean increase in flaccid length was 3.8 (1.5-6) cm. The mean increase in girth was 4.2 (2.5-5.5) cm. The patient reported satisfaction rates were 85%. No serious adverse events were encountered; the following complications were recorded: partial fat absorption occurred in 120 patients (21.4%) and was managed by fat top up. Phimosis occurred in 20 patients (3.5%) and was manged conservatively in all but 2 patients who required a circumcision, hard fat lumps occurred 30 patients (5.3%) and was managed by in office needling. Migration of fat in the scrotum occurred in 40 patients (7.1%) and was managed conservatively in all but 5 patients who required surgical removal of the fat lumps, infection of the silicon buffer occurred in 6 patients (1.07%) and was managed by removal of the silicon buffer, discomfort from the silicon buffer occurred in 5 patients (0.89%) and was managed by removal of the silicon buffer. Conclusions Penile enlargement by division of the penile suspensory ligament and injection of autologous fat is a safe and effective procedure which is associated with high patient-satisfaction rates. Disclosure No.

(216) Efficacy of Novel Hyaluronic Acid Dermal Filler Injections for Penile Girth Enhancement

Abstract Introduction There has been renewed public and professional interest in the topic of cosmetic penile girth enhancement. Hyaluronic acid (HA) injections have been proposed as a safer alternative to surgical options, however limited data exist regarding efficacy. Objective The purpose of our study was to evaluate average girth changes and related metrics in men undergoing penile girth enhancement with sequential administration of HA dermal filler at a single site. Methods We performed a retrospective review of men who underwent penile girth enhancement with HA from May 17, 2022 to April 28, 2023. Results 155 men underwent penile girth enhancement with HA filler and were instructed to follow a strict post-injection protocol. On average, men experienced a 0.633 cm increase in girth per treatment receiving an average of 12.5 total syringes over 2.2 treatments. Ultimately, all men receiving multiple treatments experienced an average girth increase of 1.8 cm as measured prior to their final treatment. 23 men who received 4 treatments or more experienced an average girth increase of 2.952 cm as measured prior to their final treatment. Of the 155 men treated, 19 (12.3%) required cosmetic correction with either hyaluronidase or abobotulinumtoxinA. Conclusions Our study suggests that injection of HA dermal filler is an effective option for men desiring non-surgical penile girth enhancement. Further studies are needed to better characterize outcomes and optimal treatment protocols. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: PhalloFill.

(051) Safety of Novel Hyaluronic Acid Dermal Filler Injections for Penile Girth Enhancement

Abstract Introduction Limited data exist regarding safety of penile girth enhancement treatments. Reported options for girth enhancement include injections of autologous fat, liquid silicone, hyaluronic acid (HA), or polymethyl-methacrylate, grafting with dermal fat, porcine dermal acellular matrix, or acellular collagen matrix, and surgical placement of a silicone implant. Objective The purpose of our study was to retrospectively evaluate safety in a cohort of men undergoing penile girth enhancement with HA dermal filler at a single site by reporting on post-procedure complications. Methods We performed a retrospective review of men who underwent penile girth enhancement with HA dermal filler from August 2020 through April 2023. Results 471 men underwent penile girth enhancement with HA dermal filler. Two patients experienced injection site infections related to non-compliance post treatment with infection resolution after completing a course of oral antibiotic. One patient reported urinary tract infection symptoms shortly after HA dermal filler procedure and subsequently underwent additional filler injections without recurrence of urinary symptoms. One patient underwent reversal with hyaluronidase after his initial treatment. Three patients developed granulomas which were completely resolved with a single treatment of hyaluronidase. All three of these patients underwent additional HA injections without granuloma formation. Three patients experienced priapism treated without long term sequelae when intracavernosal injection (ICI) therapy was used for tumescence at time of filler injection. Once ICI was no longer used, no patients reported priapism. No patients reported erectile dysfunction or loss of sensitivity. Conclusions Our study suggests that injection of HA dermal filler may be a safe option for men interested in penile girth enhancement. While rare complications may occur, our research suggests they are easily treatable in the outpatient setting without long term sequelae. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: PhalloFill.

(050) Safety and Efficacy of Hyaluronic Acid Injections Using the UroFill™ Technique for Penile Girth Enhancement

Abstract Introduction Penile girth enhancement (PGE) has gained significant popularity and is in high demand among individuals seeking to improve their sexual experiences and self-confidence. Perception of penile length and girth are integral components of the male psyche. Unfortunately, current treatment options for motivated patients looking to enhance penile girth fall short of patient and clinical expectations. While the safety of penile augmentation methods has been a subject of debate, hyaluronic acid (HA) fillers have demonstrated proven efficacy and safety, offering potential solutions for those interested in PGE. Advancements in the field of penile cosmetics with HA has led to the development of the UroFill™ patented technique for PGE. Objective To assess the safety and efficacy of injecting HA using the UroFill™ technique for PGE. Methods We performed a retrospective analysis of men undergoing penile girth enhancement with FDA-approved HA fillers between October 2021 and March 2023. Patients completed a series of validated questionnaires including the COPS-P, IIEF, and BAPS. Peri- and post-procedure adverse events were closely monitored. Physician follow-up appointments and patient questionnaires were utilized to identify and document these events. The determination of unsatisfactory cosmetic outcomes and the need for revision was made by the treating physician in consultation with the patient. The UroFill™ standardized technique was employed for all injections. Results A total of 300 men (mean age: 37, range 21-80) received treatment using the UroFill™ standardized technique. 4,879 injections were performed over this time. Mean injection volume was 16.5 cc (range: 4-78cc) of HA once treatment had been completed. The study observed an average of 3.85 injection sessions (range: 1-44 sessions) and 5.25 post-injection modeling sessions (range 0-55) per patient. After receiving HA dermal fillers, patients experienced local injection site reactions such as bruising, tenderness, swelling, and erythema. These events were generally mild in intensity, and no patient reported bruising lasting longer than 7 days. None of the patients in this cohort required removal of filler. Adverse reactions were limited to 8 cases of localized skin infections which were successfully treated with conservative antibiotic therapy. All localized skin infections were a result of premature sexual intercourse or shaving in the area following injection. Patients reported high levels of satisfaction with 272/300 (91%) reporting “completely satisfied” or “mostly satisfied”. Mean filler retention was 90% after 12 months. Conclusions This study provides evidence that the UroFill™ standardized technique for penile girth enhancement using HA fillers is both safe and efficacious. With no instances of filler removal and successful management of adverse reactions, the safety profile of HA fillers is further supported. These findings reinforce HA’s potential for sustainable penile enhancement. It is essential these procedures be performed in the described fashion by qualified urological professionals. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Coloplast, Boston Scientific, UroFill.

(174) Use of Penuma® for Correction of Residual Deformity following Previous Treatment of Peyronie’s disease: Case Series

Abstract Introduction Over the years, numerous treatment approaches have been explored for Peyronie's disease (PD) including non-surgical and surgical options. Nevertheless, the current options are largely insufficient in effectively correcting residual penile deformities after treatment. Objective To evaluate the efficacy of utilizing the subcutaneous silicone penile prosthesis (Penuma®) as a treatment modality for correcting residual penile deformity, including curvature and indentation, and providing penile girth enhancement post-PD treatment. Methods This is a two center case series of three patients who had previously undergone various treatments for PD. Detailed data about these patients were collected including their demographics, PD characteristics, previous treatments, and outcomes (see table). These patients previously had different treatments including non-surgical i.e. Xiaflex® and/or surgical options i.e. plication procedure. The placement of Penuma® subcutaneous silicone penile prosthesis was performed in a standardized manner across all cases. Follow-up evaluations were conducted to assess the effectiveness of the procedure and any associated complications. Results The main findings of the study revealed successful correction of residual penile deformity (curvature, indentation, narrowing) as well as significant improvement in penile girth in all three cases following the placement of the Penuma® subcutaneous silicone penile prosthesis. The procedure resulted in improved sexual function and satisfactory aesthetic outcomes as reported by patients. No major complications were observed during the follow-up period. Conclusions Our case series demonstrates the potential effectiveness and benefits of using Penuma® to correct residual penile deformity and to provide penile girth enhancement in patients post-PD treatment. At this time, we would consider offering Penuma® implantation when residual curvature is less than 30 degrees and indentation does not cause any instability or hinge-effect during penetrative sexual activity. Further research and larger case studies are warranted to validate these findings and assess long-term outcomes and patient-reported satisfaction. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: IMD.

Efficacy and complications of hyaluronic acid and polylactic acid for penile augmentation: a systematic review and meta-analysis.

Penile size is considered a symbol of manhood and is a subjective problem for men, especially those with small penis syndrome. Penile augmentation was introduced to correct penile size problems from a medical, psychological, or esthetic point of view. Hyaluronic acid (HA) and polylactic acid (PLA) are two types of augmentation agents that are popularly used today. However, no systematic studies and meta-analyses have compared these two modalities as penile augmentation agents. This study aimed to analyze the efficacy and safety of penile filler injections with HA compared to PLA. This study was based on the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. Articles examining the differences in efficacy and adverse events of the administration of HA and PLA in patients undergoing penile augmentation were systematically reviewed from the PubMed, Proquest, Web of Science, and Scopus databases. An odds ratio with a 95% CI was applied to measure the study outcome. The analysis was performed with RevMan 5.4 software. The risk of bias for each study was evaluated using the Risk of Bias v2 instrument from Cochrane. This research protocol is registered in the International Prospective Register of Systematic Reviews (PROSPERO) registry. Four articles consisting of 283 research subjects were included in this study. The meta-analysis for penile girth enhancement after penile augmentation found significant results in the HA group compared to the PLA group (P=0.01). There was no difference in the level of satisfaction with penile appearance 4 weeks after penile augmentation in the HA group compared to the PLA group (P=0.79). HA was significantly superior in sexual satisfaction 12 weeks postpenile augmentation (P=0.0004). There was no difference in the incidence of pain after penile augmentation in the HA group compared to the PLA group (P=0.33). In the postaugmentation penile inflammation, there was no difference (P=0.98) in the HA group compared to the PLA group. There are differences in the efficacy of penile augmentation with the superiority of HA in increasing penile diameter and postaugmentation sexual satisfaction compared to PLA. There was no difference in the incidence of complications between using HA and PLA.

The Efficacy of Injection Penile Girth Enhancement as an Option for Small Penis Syndrome Management.

In recent years aesthetic injection techniques using soft tissue fillers are becoming popular worldwide due to their effectiveness, safety, and low cost. There is no standard approach for the management and follow-up of patients seeking penile enlargement procedures described in the literature and the surgical penile enlargement methods are also controversial. To assess the effect of injection penile girth enlargement on sexual relationship satisfaction, confidence, self-esteem, and to evaluate the clinical efficacy and safety of this procedure for the management of men with small penis syndrome (SPS). This is a single-center, clinical case series study executed from January 2019 to February 2021, that involved 148 men who were unsatisfied with the shape of their normal-sized penises and requested penis girth correction. A total of 132 patients completed full treatment and follow-up. Mean girth enlargement was 1.7 ± 0.32 cm for the mid-shaft and 1.5 ± 0.32 cm for the glans of the penis. Satisfaction with sexual life improved. Mean scores increased by 17.9 ± 3.04 points for the sexual relationship and by 12.2 ± 3.17 points for the confidence. The self-esteem mean score raised by 8 ± 2.8 and by 4.3 ± 0.97 points for the overall relationship. Penile enlargement with hyaluronic acid (HA) injection positively affects sexual relationship satisfaction, confidence, and self-esteem of men with SPS. But the rate of psychosocial improvement does not correlate with penile size changes. It is a simple, safe, and effective technique that can be used in daily clinical practice.

Penile Girth Enhancement Using Amniotic Membrane in a Rabbit Model: A stereological study.

This study aimed to evaluate the efficacy of penile girth enhancement (PGE) using amniotic membrane (AM) as a graft in a rabbit model. Additionally, quantitative histological data of the structure of the penis were obtained by stereological studies. This study was conducted at the Histomorphometry and Stereology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. In this study, 20 adult male rabbits of similar age and weight were allocated to two groups: sham surgery and surgery+AM. Both groups underwent surgery in which a longitudinal I-shaped midline incision was made in the tunica albuginea on the dorsal surface of the penis. The surgery+AM group underwent PGE using AM as a graft. The penile length and mid circumference were measured using a vernier caliper before and two months after the surgery. The mean total volume and diameter of the penis significantly increased in the surgery+AM group (P <0.03 and P <0.04, respectively). On stereological evaluation, a significant increase in the mean volumes of the tunica albuginea and corpora cavernosa was observed in the surgery+AM group compared to the sham group (P <0.01 and P <0.03, respectively). Additionally, the mean volume densities of the collagen bundles, muscle fibres, cavernous sinuses, and the total number of fibroblasts and smooth muscle cells increased in the surgery+AM group compared to the sham group (P <0.05 each). No infections, bleeding or other complications were observed. The use of AM as a graft is a method that shows promising results for material use in penile enhancement. Thus, it may be considered for PGE in the future.

PD28-12 MODIFIED TEP: A NOVEL WAY TO OPTIMIZE PENILE GIRTH AND LENGTH ENHANCEMENT POST IPP

You have accessJournal of UrologyCME1 May 2022PD28-12 MODIFIED TEP: A NOVEL WAY TO OPTIMIZE PENILE GIRTH AND LENGTH ENHANCEMENT POST IPP Shirin Razdan, Ariel Zisman, and Robert Valenzuela Shirin RazdanShirin Razdan More articles by this author , Ariel ZismanAriel Zisman More articles by this author , and Robert ValenzuelaRobert Valenzuela More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002576.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Three piece penile prosthesis (IPP) surgery is the gold standard surgical treatment of erectile dysfunction. As this procedure is associated with penile shortening in inexperienced hands, many techniques created by experienced surgeons exist in the literature to optimize penile length and ensure proper cylinder sizing. Here we present our data on a modification of the existing tunica expansion procedure (TEP) for penile length restoration. METHODS: A retrospective review of IPP placement from one high volume surgeon was performed. A total of 474 patients’ charts from June 2017 to June 2021 were reviewed and those charts of patients undergoing modified TEP were analyzed. The modification entails alternating between vertical and horizontal scoring of the tunica albuginea, with vertical scoring contributing to increased penile length and horizontal scoring contributing to increased penile girth. Endpoints were average increase in prosthesis length as well as average increase in girth. RESULTS: A total of 23 patients from the larger cohort underwent modified TEP. All patients underwent IPP placement via scrotal approach. In patients undergoing vertical modification of TEP (n=15), average increase in length of distal corpora was 2.8cm. This was measured using Furlow before and after penile degloving with TEP. In patients undergoing horizontal TEP (n=8), average increase in girth was 1.6cm. This was measured at midphallus pre-procedure and after full inflation of prosthesis. There were no reported complications for these 23 cases. CONCLUSIONS: In men undergoing IPP placement, modification of the already existing TEP can allow for measurable increase in penile length and girth of almost 3 and 2cm respectively. This is an important technique within the arsenal of the prosthetic urologist to ensure cosmesis post IPP placement is optimized. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e503 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Shirin Razdan More articles by this author Ariel Zisman More articles by this author Robert Valenzuela More articles by this author Expand All Advertisement PDF DownloadLoading ...

MP04-17 DERMAL FAT GRAFT FOR PENIS ENHANCEMENT—SINGLE CENTER RESULTS

You have accessJournal of UrologyTrauma/Reconstruction/Diversion: External Genitalia Reconstruction and Urotrauma (including transgender surgery) I (MP04)1 Sep 2021MP04-17 DERMAL FAT GRAFT FOR PENIS ENHANCEMENT—SINGLE CENTER RESULTS Borko Stojanovic, Marko Bencic, Marta Bizic, and Miroslav Djordjevic Borko StojanovicBorko Stojanovic More articles by this author , Marko BencicMarko Bencic More articles by this author , Marta BizicMarta Bizic More articles by this author , and Miroslav DjordjevicMiroslav Djordjevic More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001971.17AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The size of a penis is of great concern among men of all ages. Different methods for penile girth enhancement have been reported, and most of them are controversial and poorly evaluated. We assessed outcomes of penis enhancement surgery with autologous dermal fat graft in our center. METHODS: A total of 42 men with penile dysmorphophobia, with a mean age of 37 years (range 27-52) underwent penis enhancement surgery with dermal fat graft harvested from gluteal region from March 2015 to December 2019. Procedure included harvesting of the gluteal dermal fat graft, with the incision placed into the gluteal fold. Using circumcision incision, penile degloving is performed, while fat is trimmed, and graft is symmetrically placed around the penile shaft and fixed to the Bucks fascia close to the urethra with 4.0 polydioxanone interrupted sutures. Use of penile vacuum device was advised to the patients for the period of 6 months postoperatively. Girth measurements were taken in the flaccid and erect condition, preoperatively and 6 months postoperatively. RESULTS: Mean follow-up was 38 months (range from 14 to 71 months). Mean value of circumference gain after surgery was 1.23±0.24 cm (range from 0.62–2.53 cm). Postoperative complications included prolonged hematoma of the donor region, infection of the wound and partial necrosis of the penile shaft, in 3, 1 and 2 cases, respectively. All complications were successfully treated conservatively. Majority of patients (94%) were satisfied with the postoperative result, while 2 patients required additional penile enlargement and penile lengthening. CONCLUSIONS: Penis enhancement surgery with autologous dermal fat graft is safe procedure that provides good cosmetic outcome, and high rate of patient's satisfaction, with low complication rate. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e73-e73 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Borko Stojanovic More articles by this author Marko Bencic More articles by this author Marta Bizic More articles by this author Miroslav Djordjevic More articles by this author Expand All Advertisement Loading ...

Penile girth enhancement procedures for aesthetic purposes.

The present study aimed to describe and critically discuss the current evidence regarding the penile girth enhancement procedures for aesthetic purposes. We designed a narrative review of the literature. A comprehensive search in the MEDLINE database was performed. Original articles in English-language, published until March 2021, were selected. A total of 29 studies were included (3 reporting non-invasive approaches, 11 injection therapies, and 15 surgical procedures). The vast majority of articles (26, 89.7%) were not randomized controlled trials, with overall low quality and limited level of evidence. Only 1 (33.3%) paper regarding non-invasive approaches reported a minimal (+0.03 cm) but a significant increase of penile girth (p = 0.034). A low rate (11.2-14.4%) of mild, temporary adverse events and poor-to-moderate patient satisfaction were found. Eight (72.7%) articles concerning injection therapies showed a significant increase in penile girth (p < 0.05). A low rate of mild complications, generally at the injection site, and a high patient satisfaction rate (75-100%) were highlighted. Nine (60%) papers on surgical treatments found a significant increase in penile girth (p < 0.05), while the other 6 (40%) studies reported a generic improvement in penile circumference. Skin necrosis or ulcers, wound infections, or need for reoperation were reported in 8 (53.3%) studies. A high patient satisfaction rate (60-100%) was reported. Our review highlighted the overall positive results of injection procedures, the poor outcomes associated with non-invasive techniques, and the good efficacy and satisfaction with a non-negligible risk of complications in patients undergoing surgical treatments. However, the adverse events are probably largely under-reported and these procedures should still be considered under investigation due to the limited evidence available and the lack of guidelines.

Efficacy and Safety of Penile Girth Enhancement Using Hyaluronic Acid Filler and the Clinical Impact on Ejaculation: A Multi-Center, Patient/Evaluator-Blinded, Randomized Active-Controlled Trial.

PurposeWe aimed to evaluate the efficacy and safety of penile girth enhancement (PGE) using hyaluronic acid (HA) filler with different physical properties from previous studies. Additionally, we evaluated the clinical impact on ejaculation after PGE.Materials and MethodsThis was a prospective, patient/evaluator-blinded, randomized, active-controlled, multicenter trial. Patients recruited between December 2017 and March 2018 were randomly assigned to the HA filler or control group (polylactic acid [PLA] filler). Penile girth, satisfaction level, Premature Ejaculation Profile (PEP), and self-estimated intravaginal ejaculation latency time (IELT) were assessed at baseline and at 24 weeks post-injection.ResultsSixty-four subjects (32 in each group) completed the trial. The mean increase in girth was 22.74±12.60 mm and 20.23±8.73 mm in the HA and control groups, respectively. Satisfaction level regarding penile appearance and sexual life significantly increased in both groups. There was no statistically significant difference between the groups in terms of increase in penile girth or change in satisfaction level. Both groups showed significant improvements in PEP index scores. Self-estimated IELT also significantly increased in the HA group (from 5.36±3.51 to 7.86±4.73 minutes, p=0.0001) and control group (from 5.23±3.55 to 6.43±4.22 minutes, p=0.021). No serious adverse events (AEs) were reported.ConclusionsPGE with HA and PLA fillers resulted in significant enhancement of girth without serious AEs with no significant differences. Furthermore, PGE using filler improved clinical symptoms related to ejaculation.

P-02-22 The Effect of Penile Girth Enhancement Using Filler in the Ejaculation

P-02-22 The Effect of Penile Girth Enhancement Using Filler in the Ejaculation

MP29-13 AUTOLOGOUS DERMAL GRAFT IN THE TREATMENT OF PENILE DYSMORPHOPHOBIA

INTRODUCTION AND OBJECTIVE:Different methods for penile girth enhancement have been reported, and most of them are controversial and poorly evaluated. We analyzed outcomes of penile enhancement sur...

Complications and Management of Penile Girth Enhancement with Acellular Dermal Matrix

IntroductionAcellular dermal matrix (ADM) is a common filler used widely in clinical practice to increase penile girth for cosmetic reasons, but there are few studies on its complications. AimThe aim of this study was to investigate and analyze the complications of penile girth enhancement (PGE) with ADM. MethodsThe medical records of 78 patients who underwent PGE with ADM between June 2016 and January 2019 were retrospectively reviewed. Main Outcome MeasureRelated complications and their subsequent management were summarized and analyzed. Results78 patients (mean age 31.14 years [21−66 years]) received PGE with ADM. At the 3-month follow-up, the penile circumference was increased by 1.1 (0.5−2.1) cm on average. There were 47 patients with erectile discomfort, 12 with delayed healing, 10 with unobvious augmentation effect, 8 with wound hematoma, 7 with prepuce edema, 4 with wound infection, and 3 patients with skin necrosis of the dorsal side. 7 patients eventually underwent ADM removal. Clinical ImplicationsThese adverse complications indicate that ADM should be used with caution for PGE. Strength & LimitationsThis study adds important data, as there are few published reports on the complications of PGE with ADM. However, this study did not compare postoperative complications with ADM to those seen with other filler material. ConclusionEven with standardized surgical methods and rigorous postoperative care, complications of PGE using ADM are severe, which indicates that it is not an ideal or safe method for PGE.Xu T, Zhang G, Bai W, et al. Complications and Management of Penile Girth Enhancement with Acellular Dermal Matrix. J Sex Med 2019;16:2011–2017.

Penile Girth Enlargement Strategies: What's the Evidence?

Most men seeking penile girth augmentation have physiologically normal penises but may suffer from severe preoccupation with penis size known as penile dysmorphophobic disorder. To describe the medical, procedural, and reconstructive techniques available for penile girth enhancement and to review the success and complications of each modality. A comprehensive review of peer-reviewed publications on the topic was performed through a PubMed search. Key search terms included penis, enhancement, enlargement, phalloplasty, reconstruction, girth, and augmentation. We wanted to summarize the motivations behind penile girth enhancement and review the outcomes for girth augmentation treatments. Various medical, traction, injection, prosthetic, and reconstructive modalities have been studied for penile girth enhancement, with increases in girth ranging from 0-4.9 cm. Complications were reported in a minority of patients, but they may be devastating and include penile fibrosis, sexual dysfunction, device infection, and death. A variety of penile girth augmentation techniques have been studied. Clinical guidelines are lacking, and complications of penile girth enhancement are likely underreported. Until more rigorous investigation with accurate reporting of complications is achieved, penile girth augmentation procedures should be considered experimental. Hehemann MC, Towe M, Huynh LM, etal. Penile Girth Enlargement Strategies: What's the Evidence? Sex Med 2019;7:535-547.

232 Efficacy and safety of Volus (hyaluronic acid) for penile girth enhancement: multi-center, randomized, subject blind, active controlled study

232 Efficacy and safety of Volus (hyaluronic acid) for penile girth enhancement: multi-center, randomized, subject blind, active controlled study

Repeated penile girth enhancement with biodegradable scaffolds: Microscopic ultrastructural analysis and surgical benefits.

Autologous tissue engineering using biodegradable scaffolds as a carrier is a well-known procedure for penile girth enhancement. We evaluated a group of previously treated patients with the aim to analyze histomorphometric changes after tissue remodeling and to estimate the benefits of repeated procedure. Between February 2012 and December 2016, a group of 21 patients, aged 22–37 (mean 28.0) years, underwent a repeated penile girth enhancement procedure with biodegradable scaffolds. Procedure included insertion of two poly-lactic-co-glycolic acid scaffolds seeded with laboratory-prepared fibroblasts from scrotal tissue specimens. During this procedure, biopsy specimens of tissue formed after the first surgery were taken for microscopic analysis. The mean follow-up was 38 months. Connective tissue with an abundance of connective tissue fibers, small blood vessels, and inflammatory cells were observed in all analyzed surgically removed tissue. Ultrastructural analysis of these tissue samples discovered the presence of large quantities of collagen fibrils running parallel to each other, forming bundles, with a few widely spread fibroblasts. In total, the mean values of flaccid and erect gain in girth after the second surgery were 1.1 ± 0.4 (range: 0.6–1.7) cm and 1.0 ± 0.3 (range: 0.6–1.5) cm, respectively. Microscopic evaluation of newly formed tissue, induced by autologous tissue engineering using biodegradable scaffolds, showed the presence of vascularized loose connective tissue with an abundance of collagen fibers, fibroblasts, and inflammatory cells, indicating active neovascularization and fibrinogenesis. The benefit of the repeated enhancement procedure was statistically significant.

Editorial Comment on “Penile Girth Enhancement With PMMA-Based Soft Tissue Fillers”

Editorial Comment on “Penile Girth Enhancement With PMMA-Based Soft Tissue Fillers”