Penile Girth Research Articles

Outcomes of variation in technique and variation in accuracy of measurement in penile length measurement.

Accurate data regarding the size of the erect penis is of great importance to several disciplines working with male patients, but little data exists on the best technique to measure penile length. While some previous small studies have suggested good correlation between stretched penile length, others have shown significant variability. Penile girth has been less well studied, and little data exist on the possible errors induced by differing observers and different techniques. Much of the published data report penile length measured from the penopubic skin junction-to-glans tip (STT) rather than pubic bone-to-tip (BTT). We wished to assess the accuracy of different techniques of penile measurements with multiple observers. Men who achieved full erection using dynamic penile Doppler ultrasound for the diagnosis of sexual dysfunction or a desire for objective penile measurement were included in the study. Exclusion criteria were penile scarring, curvature, or congenital abnormality. In each case, the penis was measured by one of the seven andrology specialists in a private air-conditioned (21 °C) environment. Each patient had three parameters measured: circumference (girth) of the penile shaft, length from suprapubic skin-to-distal glans (STT), and pubis-to-distal glans (BTT). The three measurements were recorded in the stretched flaccid state, and the same three measurements were then repeated in the fully erect state, following induction of full erection with intracavernosal injection. We analyzed the accuracy of each flaccid measurement using the erect measurements as a reference, for the overall patient population and for each observer. In total, 201 adult men (mean age 49.4 years) were included in this study. Assessing the penis in the stretched and flaccid state gave a mean underestimate of the erect measurement of ~20% (STT length 23.39%, BTT length 19.86%, and circumference 21.38%). In this large, multicenter, multi-observer study of penis size, flaccid measurements were only moderately accurate in predicting erect size. They were also significantly observer dependent. Measuring penile length from pubic bone to tip of glans is more accurate and reliable, the discrepancy being most notable in overweight patients.

Nonsurgical Medical Penile Girth Augmentation: Experience-Based Recommendations.

Penile augmentation is increasingly sought by men who are dissatisfied with the size and/or appearance of their penis. However, augmentation procedures are still considered to be highly controversial with no standardized recommendations reported in the medical literature and limited outcome data. Nevertheless, these procedures continue to be performed in increasing numbers in private settings. Therefore, there is a need for safe, effective, and minimally invasive procedures to be developed, evaluated, and reported in the research literature. In this article, we focus particularly on girth enhancement procedures rather than lengthening procedures as penile girth appears to be particularly important for sexual satisfaction. We discuss the advantages and disadvantages of the common techniques to date, with a focus on the minimally invasive injectable girth augmentation techniques. Based on considerable operative experience, we offer our own suggestions for patient screening, technique selection, and perioperative care.

Original Technique for Penile Girth Augmentation Through Dermal Acellular Grafts

Although different techniques for augmentation phalloplasty have been reported in the medical. literature, this issue is still highly controversial, and none of the proposed procedures has been unanimously. approved. Between 2000 and 2016, 156 patients were referred to our institution for penile enhancement. The average penis circumference was measured at the mid-length of the penis and was 8.1 cm (5.4–10.7 cm) and 10.8 cm (6.5–15.8 cm) during flaccidity and erection, respectively. All patients received penile augmentation with dermal acellular grafts. Postoperative measurements were performed at 6 and 12 months. At the 1-year follow-up, the average penis circumference was 11.3 cm (8.2–13.2 cm, 3.1 cm mean increase) during flaccidity and 13.2 cm (8.8–14.5 cm, 2.4 cm mean increase) during erection. No major complications occurred in the series. Minor complications were resolved with conservative treatment within 3 weeks. Sexual activity was resumed from 1 to 2 months after surgery. The psychosexual impact of the operation was beneficial in the majority of cases.

Efficacy and safety of a newly developed polylactic acid microsphere as an injectable bulking agent for penile augmentation: 18-months follow-up.

Polylactic acid (PLA) fillers are widely used for cosmetic volume augmentation. But, no study has evaluated the use of PLA filler in penile augmentation (PA No. 4). We evaluated the efficacy and safety of a newly developed PLA filler for PA during a 18-month follow-up period. A total of 23 healthy adult men were prospectively enrolled between June and November 2012. Penile girth was measured at proximal-, mid- and distal-shaft at baseline, 3, 6, 12 and 18 months following injection. Subjects' satisfaction was assessed with visual analogue scale (VAS). Adverse events (AEs) were also reported. Mean injected volume was 20 ml. The circumference of proximal-, mid-, and distal-shaft increased by a mean of 2.2±0.2, 2.7±1.0 and 2.7±1.0 cm at 3 months, respectively (each P<0.001). No significant differences were noted in girth circumference between 3 and 18 months post-injection (each P>0.05). VAS score increased from 51.6±14.7 at baseline to 64.8±19.3 and 74.3±14.6 at 3 and 6 months, respectively (each P<0.05). Six cases of mild, transient treatment-emergent AEs were reported in 5 subjects. Serious AEs were not reported. In conclusion, penile injection of a newly developed PLA filler led to significant penile augmentative effects for up to 18 months and was well tolerated without serious AEs.

Penile Lengthening, Girth, and Size Preservation at the Time of Penile Prosthesis Insertion.

Penile prosthetic devices are the gold standard treatment of medication-refractory erectile dysfunction. Inflatable penile prosthetic (IPP) devices have been available and used for more than four decades. Oftentimes, medical conditions causing erectile dysfunction also cause penile shortening, causing decreased patient quality of life. To identify and review all available penile lengthening procedures that can be performed at time of IPP insertion. An extensive, systematic literature review was performed using PubMed searching for key terms penile lengthening, inflatable penile prosthesis, penile girth, corporoplasty, glans augmentation, and penile enhancement; all articles with subjective and/or objective penile length outcomes were reviewed. A review of various techniques for penile length and girth preservation and enhancement during penile prosthesis insertion. Several advanced and novel techniques were found for penile length preservation and enhancement at time of IPP insertion, including the sub-coronal IPP insertion technique, and adjuvant maneuvers during insertion, such as the sliding technique, modified sliding technique, multiple slice technique, and circumferential incision and grafting. Other adjuvant techniques that can enhance perception of increased length include ventral phalloplasty, suprapubic lipectomy, and suspensory ligament release. Further enhancement can be obtained using augmentation corporoplasty and glans augmentation with hyaluronic acid and other fillers. The different techniques vary in complexity and could require specialized training and experience. Maximum length gain appears to be limited by the length of the neurovascular bundles. Overall, surgical penile lengthening procedures at time of IPP insertion appear safe and effective for treatment of patients with penile shortening and severe erectile dysfunction. These therapies can significantly improve patient self-esteem and quality of life in properly selected patients. Tran H, Goldfarb R, Ackerman A, Valenxuela RJ. Penile Lengthening, Girth and Size Preservation at the Time of Penile Prosthesis Insertion. Sex Med Rev 2017;5:403-412.

Penile Enlargement Surgery: Is It Feasible?

Penile size is a major concern among men all over world. Men throughout history and still today, feel the need to enlarge their penis in order to improve their self-esteem and sexual performance. There are a variety of social, cultural, and psychological aspects regarding the size of men genitals, resulting such that, men often feel the need to enlarge their penis. “Bigger is better” is still a relevant belief in our days and based on the “phallic identity” – the tendency of males to seek their personality in their penis. This trend is supported by the numerous and still increasing number of penile enlargement procedures performed in the past years and today, generally in men with normal size penises. This condition is called “the locker room syndrome” – men concerned about their flaccid penile size even though in most cases their penile length and girth are normal. however, the surgical procedures available for changing penile appearance remains highly controversial mainly due to high complication rates and low satisfactory surgical outcomes.

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

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

Response and Rebuttal to Editorial Comment Regarding “Penile Girth Enhancement With PMMA-Based Soft Tissue Fillers”

Response and Rebuttal to Editorial Comment Regarding “Penile Girth Enhancement With PMMA-Based Soft Tissue Fillers”

Penile Girth Enhancement With Polymethylmethacrylate-Based Soft Tissue Fillers

IntroductionAn unknown percentage of men will take every risk to develop a larger penis. Thus far, most injectables have caused serious problems. Polymethylmethacrylate (PMMA) microspheres have been injected as a wrinkle filler and volumizer with increasing safety since 1989. AimTo report on a safe and permanently effective method to enhance penile girth and length with an approved dermal filler (ie, PMMA). MethodsSince 2007, the senior author has performed penile augmentation in 752 men mainly with Metacrill, a suspension of PMMA microspheres in carboxymethyl-cellulose. Main Outcome MeasuresThe data of 729 patients and 203 completed questionnaires were evaluated statistically. ResultsThe overall satisfaction rate was 8.7 on a scale of 1 to 10. After one to three injection sessions, average girth increased by 3.5 cm, or 134% (10.2 to 13.7 cm = 134.31%). Penile length also increased by weight and stretching force of the implant from an average of 9.8 to 10.5 cm. Approximately half the patients perceived some irregularities of the implant, which caused no problems. Complications occurred in 0.4%, when PMMA nodules had to be surgically removed in three of the 24% of patients who had a non-circumcised penis. ConclusionAfter 5 years of development, penile augmentation with PMMA microspheres appears to be a natural, safe, and permanently effective method. The only complication of nodule formation and other irregularities can be overcome by an improved injection technique and better postimplantation care.

Modified Penile Augmentation by Dermal-Fat Graft in Post-Hypospadias Adults

Although a considerable part of patients desire further improvement in penile size after hypospadias repairs, penile augmentation is only considered in patients with congenital penile hypoplasia or acquired penile retraction. Modified penile augmentation by free dermal-fat graft is introduced to satisfy these patients and improve surgical safety. From April 2012 to December 2014, a total of 15 male adults after hypospadias repairs, aged 18-24 years, underwent modified penile augmentation which involved girth enhancement by a free dermal-fat graft and penile elongation (suprapubic skin advancement-ligamentolysis). A specially designed tunneling instrument was introduced to facilitate pericavernous thickening without degloving. Outcome evaluation was mainly based on objective penile measurements and results of the Male Genital Image Scale. With 6 months' follow-up, all patients had achieved excellent cosmetic results, with a significant average dimensional increase of 1.53 ± 0.23 cm in flaccid girth and 1.67 ± 0.24 cm in flaccid length. No erection deficiencies or urinary fistula occurred. Patients' perception of male genitalia improved postoperatively, with the average MGIS score rising from 31.73 ± 4.86 to 40.20 ± 4.54. This modified technique is safe and effective in enlarging penile size. The use of the specially designed tunneling instrument simplifies penile girth enhancement, avoiding unnecessary trauma to the neo-urethra and neurovascular bundle. It is confirmed that physical dimensional enhancement does contribute to improving their underestimation of penile size. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Effects of Stem Cell Treatment in Human Patients With Peyronie Disease.

Peyronie disease (PD) is a connective tissue disorder involving the formation of fibrous plaques in the tunica albuginea. Abnormal plaques and scar tissue create a chronic state of inflammation, causing increased curvature of the penis as well as erectile dysfunction. To determine the feasibility and effects of using placental matrix-derived mesenchymal stem cells (PM-MSCs) in the management of PD. In a prospective study, patients with PD were injected with PM-MSCs, and followed up at 6-week, 3-month, and 6-month intervals to assess changes in plaque volume, penile curvature, and erectile function status (measured using peak systolic velocity, end-diastolic velocity, and the International Index of Erectile Function questionnaire). In the 5 patients enrolled in the study, statistically significant increases in peak systolic velocity occurred after PM-MSC injection (P<.01). Of a total of 10 plaques managed, 7 had disappeared completely at 3-month follow-up. Changes in end-diastolic velocity, stretched penile length, and penile girth were not statistically significant. To our knowledge, this study is the first on the use of stem cells to manage PD in humans. The results suggest that PM-MSCs may be beneficial and effective as a nonsurgical treatment in patients with PD. Future studies with long-term follow-up in a larger sample of patients are warranted. (ClinicalTrials.gov number NCT02395029).

Use of a microdebrider for corporeal excavation and penile prosthesis implantation in men with severely fibrosed corpora cavernosa: a new minimal invasive surgical technique.

To propose a new minimal invasive surgical technique using a microdebrider (shaver) to excavate the fibrosed corpora cavernosa for penile prosthesis implantation in patients with severe fibrosis. Two patients with severe corporeal fibrosis were implanted with a penile prosthesis using this technique. In the first patient, fibrosis was due to neglected idiopathic ischemic priapism and the second patient had his prosthesis extruded because of erosion in another center. Both patients were counseled about the procedure and the possible complications related to the experimental nature of the technique. A written informed consent was obtained from both patients. Excavation of the corpora was performed using microdebrider in both patients. Both operations were performed successfully without any intraoperative complications, including urethral injury or perforation of the tunica. The mean operation time was 57 min. The postoperative period was uneventful without any infection, migration, erosion, or mechanical failure. The penile length was increased nearly 2 cm in both patients, and the penile girth was increased around 30% in the patient who underwent inflatable penile prosthesis implantation. The microdebrider potentially provides an important advance in patients with severe corporeal fibrosis to excavate the fibrosed corpora cavernosa for penile prosthesis implantation. The main advantages include fast, safe, and effective excavation of fibrous corpora cavernosa adequate for a satisfactory penile prosthesis implantation.

Applying extender devices in patients with penile dysmorphophobia: assessment of tolerability, efficacy, and impact on erectile function.

Most men seeking penile enhancement techniques have a normal penile size. They are either misinformed or suffer from penile dysmorphophobia and should be discouraged from undergoing invasive procedures. Less invasive techniques including penile extenders are not associated with major complications and may be beneficial from a psychological perspective. We conducted this study to assess the efficacy and safety of AndroPenis (Andromedical, Madrid, Spain) penile extender. Between December 2010 and December 2013, 163 men presented to our institution complaining of small penile length and/or girth. All patients received structured psychosexual counseling. Fifty-four patients were willing to use the AndroPenis penile extender after counseling. Patients with major psychiatric disorders were excluded from enrollment. The patients were instructed to wear the device between 4 and 6 hours per day for 6 months. Penile dimensions including flaccid stretched and erected lengths were measured at baseline and after 1, 3, 6, and 9 months. Erectile function was assessed at baseline and 9 months after treatment using the simplified International Index of Erectile Function (IIEF-5). An institutional nonstandardized questionnaire was used to evaluate patient satisfaction at the end of study. Penile length and girth enhancement as well as satisfaction rate and improvement in erectile function were assessed during follow-up. At 6-month follow-up, a mean gain of 1.7 ± 0.8, 1.3 ± 0.4, and 1.2 ± 0.4 cm was noted for the flaccid, stretched, and erected penile lengths, respectively (all P values < 0.001). During the off treatment period, there were no significant changes in penile lengths. No effect on penile girth was observed. Patient satisfaction survey revealed modest satisfaction. From 13 patients with mild baseline erectile dysfunction, nine patients reported normal erectile function after 9 months. Penile extender as a minimally invasive technique is safe and provides modest benefits and patient satisfaction.

MP52-15 MICROSCOPIC EVALUATION OF TISSUE REMODELING AFTER PENILE GIRTH ENHANCEMENT USING BIODEGRADABLE SCAFFOLDS

INTRODUCTION AND OBJECTIVES: Autologous tissue engineering by using biodegradable scaffolds as a carrier is proven to be an effective therapeutic approach for penile girth enhancement. The principle of this technique is to transplant autologous cells onto biocompatible and biodegradable scaffolds that will provide appropriate mechanical strength to induce three-dimensional tissue growth and consequent penile enlargement. The aim of this study was to performmicroscopic evaluation of tissue remodeling after penile girth enhancement using this technique. METHODS: Between 2007 and 2013, a group of 22 patients, aged 22-37 years, underwent repeated penile enhancement using biodegradable scaffolds, after psychiatric evaluation, and after approval of institutional review board. During repeated procedure, samples of newly formed tissue after previous surgery were obtained. Surgically removed specimens were fixed in 4% formaldehyde for light microscopy and in 3% glutaraldehyde for electron microscopy, and routinely processed for microscopic analysis. RESULTS: Connective tissue with an abundance of connective tissue fibers, with small blood vessels and inflammatory cells were seen in all analyzed surgically removed tissue. Ultrastructural analysis of these tissue samples discovered the presence of large quantity of collagen fibrils that were regularly arranged in parallel, forming bundles, with a few widely spread fibroblasts. Mast cells were present in all tissue samples and some were partly degranulated. In one sample, groups of fibroblast were observed, in contrast to other samples studied where fibroblasts were largely separated from one another with abundant collagen fibers. In these fibroblasts the presence of lipid droplets were found. Lipid droplets were small, but variable in size and number in lipidladen fibroblasts. Lysosomes were also observed in the cytoplasm of these fibroblasts. CONCLUSIONS: Microscopic evaluation of newly formed tissue induced by autologous tissue engineering by using biodegradable scaffolds showed the presence of vascularized loose connective tissue with abundance of collagen fibers, fibroblasts and inflammatory cells. These findings confirmed active neovascularization and fibrillogenesis in newly formed tissue.

S269: Long-term complications of penile girth enhancement fillers: Case series from Kuwait and review of the literature

S269: Long-term complications of penile girth enhancement fillers: Case series from Kuwait and review of the literature

AB65. Experience in the use of synthetic fillers in phalloplasty

Penis size has been a source of anxiety for men throughout history, and men often feel the need to enlarge their penises in order either to improve their self-esteem or to satisfy and impress their partners. Many different types of penile enhancement surgery are performed all over the world, although there are medico-legal issues and paucity of scientific data. An ideal procedure for phalloplasty should rely on two principles: minimal incision with limited scarring and no interference with the erectile function. Several techniques have been described to increase penile length, including cutting the suspensory ligament with or without V-Y plasty of the lower abdominal skin, possibly with fat, dermis, autologous rib cartilage, or synthetic material graft to prevent reattachment of the suspensory ligament. Liposuction or lipectomy has been used for patients with a large infrapubic pad of fat. Surgery to enhance the penile girth includes lipoinjection, dermal free or pedicle grafts, and venous grafting for the corpora cavernosa, injection of synthetic dermal filler. Currently, as the need for safer, effective and less-invasive procedures is increasing, enhancement procedures using injectable products are in high demand. Injectable soft-tissue substitutes provide an affordable, nonsurgical alternative for correcting contour defects and soft tissue augmentation with autologous fat, silicone, collagen, and hyaluronic acid, dextran filler, polylactic acid.We have developed two synthetic fillers; Cross-linked dextran and polymethylmethacrylate mixture (Lipen-10), Polylactic acid (PLA) filler.Penile lnjection of; Cross-linked dextran and polymethylmethacrylate mixture (Lipen-10) and Polylactic acid filler led to significant increase in penile size, showed a good durability and was well-tolerated, without serious adverse events.Glans penis augmentation has been performed in real practice, although it is not an established procedure. We evaluated the efficacy and safety of injectable cross-linked dextran gel for glans penis augmentation. Gel was injected into the lamina propria layer of the glans penis by the fanning technique in 18 patients. The glandular size was measured, at baseline and at 6 months after injection. As a result, there was a size increase of more than 45%. 16 subjects (88.8%) were satisfied, whereas only two (11.1%) were dissatisfied.These procedures are still experimental nature and have complexity of the patient’s psychological status, selection of the surgical technique is still highly controversial, and none of the proposed methods has been unanimously approved. In spite of this, we report our experience with cross-linked dextran and polymethylmethacrylate mixture (Lipen-10), Polylactic acid (PLA) filler, for phalloplasty and glanduloplasty performed safely with good efficacy.

Girth Augmentation of the Penis Using Flaps “Shaeer's Augmentation Phalloplasty”: The Superficial Circumflex Iliac Flap

Penile girth augmentation can be achieved by various techniques, among which are liposuction injection, synthetic grafts, and autologous grafts, with variable outcome, mostly related to viability and receptivity of the tissue used for augmentation. Flaps are considered superior to grafts considering their uninterrupted blood supply. The current work describes long-term experience with penile girth augmentation using the superficial circumflex iliac artery and vein (SCIAV) flap. SCIAV flap was used for penile girth augmentation in 40 candidates who followed up for a minimum of 18 months. The flap was mobilized from the groin region. The penis was pulled out of a peno-pubic incision. The flap was tunneled under the pubic region to emerge at the base of the penis and was sutured to the subcoronal area and on either sides of the spongiosum. Another session was required for either de-bulking of the oversized flap (four overweight candidates), flap pedicle (n = 6), or for donor site scar revision (n = 11). Gain in girth in centimeters was evaluated. Excluding dropouts (n = 8) and participants who had encountered de-bulking of the flap body (n = 4), 40 participants had a preoperative average flaccid girth (AFG) of 9.3 ± 1.1 cm. Immediately postoperative AFG was 14.9 ± 1.1 cm (P < 0.001). Postoperative AFG at the final follow-up visit (a minimum of 18 months) was 14.5 ± 1.1 cm (55.6% gain compared with baseline, P < 0.001). SCIAV flap is a reliable option for long-lasting and sizable penile girth augmentation. One-stage augmentation is more suited for non-obese candidates. A second session may be indicated in overweight candidates or for scar revision.

Shortened penis post penile prosthesis implantation treated with subcutaneous soft silicone penile implant: case report

Penile prosthesis surgery for erectile dysfunction has the highest satisfaction rates among all treatment options but is often associated with subjective and objective loss of penile length and girth following surgery. To present a novel technique using a subcutaneous soft silicone implant for reversal of penile shortening and narrowing after prosthesis surgery, with additional gains in overall penile length and girth. Nine patients were treated with the insertion of a subcutaneous soft silicone penile implant. All patients had previously reported a loss in penile length (0.5-2 cm), and seven of nine patients also reported a loss in penile girth (0.5-2.6 cm) after penile prosthesis surgery. During a follow-up period of 4-24 months, penile length and girth measurements showed a mean increase in length of 2.4 cm (±0.75 cm) and a mean increase in girth of 3.4 cm (±0.94 cm). The additional insertion of a subcutaneous soft silicone implant in patients with decreased penile length and girth after penile prosthesis surgery is an effective treatment option that provides reversal of lost penile length and girth.

An unusual delayed complication of paraffin self-injection for penile girth augmentation

BackgroundPenile self-injection of various oils is still carried out among Eastern Europe people for penile girth augmentation despite the potential destructive complications of this practice are well known. Penile reactions to such foreign bodies include scarring, abscess formation, ulceration, and even Fournier’s gangrene; voiding problems due to mineral oil self-injection have been reported only once. To our knowledge, we describe the first case of paraffin self-injection for penile girth augmentation presenting with acute urinary retention.Case presentationA 27-year-old Romanian man presented with severe penile pain and acute urinary retention five years after having practiced repeated penile self-injections of paraffin for penile girth augmentation. The penile shaft was massively enlarged, fibrotic and phymotic; urethral catheterization failed due to severe stricture of the proximal pendulum urethra. The patients refused placement of a suprapubic catheter and underwent immediate penile surgical exploration. The scarred tissue between dartos and Buck’s fascia and a fibrotic ring occluding the urethra were removed and the penile skin reconstructed. Pathology confirmed the diagnosis of paraffinoma. The patient resumed normal voiding immediately after catheter removal on second postoperative day; he was very pleased with cosmetic, sexual and voiding results at six weeks, six months and 1 year follow-up.ConclusionsThe present report describes a novel complication of penile self-injection for penile girth augmentation. Because of the increasing number of patients seeking penile augmentation, physicians dealing with sexual medicine should pay more attention to such request to prevent the use of non medical treatments that can turn into medical disasters.

Intraoperative Cavernous Nerve Stimulation and Laser-Doppler Flowmetry During Radical Prostatectomy

Erectile dysfunction is a common side effect following radical prostatectomy mainly due to damage of the pelvic autonomic nerve fibers (cavernous nerves). Intraoperative electrical stimulation of the cavernous nerves while measuring changes in penile girth has previously been shown to provide the surgeon with feedback of nerve integrity. To test the feasibility of recording changes in glans penis blood flow by Laser Doppler flowmetry from cavernous nerve stimulation. Fifteen patients with localized prostate cancer undergoing radical prostatectomy had electrical stimulation of the proximal and distal parts of the neurovascular bundles after prostate removal. The stimulation consisted of 30-40 seconds biphasic constant current (10-30 mA) with 0.5 millisecond pulse duration. Stimulus induced changes in penile blood flow was recorded from a Laser Doppler probe attached to the glans penis. Changes in penile girth were simultaneously recorded from a mercury-in rubber strain gauge. Erectile function was evaluated three months after surgery. Ten patients had stimulus induced increase in Laser Doppler flow unilaterally (N=7) or bilaterally (N=3). Out of 10 patients, 6 reported some preserved erectile function postoperatively at 3 months follow-up (indicating 6 true and 4 false positives). Three patients had no Doppler response from stimulation and had no postoperative erectile function postoperatively (indicating three true negatives). Two patients were excluded from the study due to bad signal quality in the Laser Doppler signal. In the majority of patients, stimulation produced increase in penile girth sensed by the strain gauge. This preliminary report provides evidence that Laser Doppler Flowmetry is able to detect increased penile blood flow from intraoperative electrical stimulation of the neurovascular bundles. However, further improvement in the recording technique is required. Laser Doppler Flowmetry may also be feasible to confirm autonomic nerve sparing in women undergoing pelvic surgery.