man- surgery

HYPOSPADIA

It’s a pathological condition characterized by a birth defect of the urethra involving an abnormally placed urinary hole. The surgical correction is an urethral reconstruction in different steps associated to the correction of the penis recurvatum with a final better functional and cosmetic improvement.
EPISPADIA

It’s a rare disorder of the external genitalia characterized by an abnormal dorsal localization of the urinary hole frequently associated with penis recurvatum and urinary incontinence. The surgical correction is an urethral reconstruction in different steps associated to the correction of the penis recurvatum with a final better functional and cosmetic improvement.

FRENULOPLASTY

It’s a release of the frenulum of prepuce of penis due to an abnormally short or sensitive frenulum.

In many patients It makes some types of sexual activity uncomfortable or even painful. The operation is performed in 15-30 minutes under local anesthesia.
PHIMOSIS

Is a condition of the penis where the foreskin cannot be fully retracted over the glans penis. It may be congenital or acquired and leading to higher risks of infections, urinary obstruction or sexual impairment.

The therapy is surgical and performed as outpatient under local anesthesia or sedation.

Two are the main surgical techniques: circumcision (prepuce removal) or preputioplasty by the use of multiple plasties leading to a more elastic scar.

The post-operative care is easy and fast with minimal local edema. Recovery from sexual activity is about 4 weeks.

PENIS RECURVATUM

It’s frequently associated with hypospadias or epispadia and due to an anomalous development of the corpora cavernosa penis. It’s more frequent in a ventral position, sometimes lateral and rarely dorsal. During sexual activities It can become really troublesome. The surgical technique is named corporoplasty and is aimed to correct the anatomy of the penis. Three are the main corporoplasties: 1) using a tunical albuginea free graft on the convex side; 2) lengthening of the short side 3) use of dermal grafts or saphenous vein patch grafts to lengthen the short side.

ACQUIRED PENIS RECURVATUM ( Induratio penis plastica or Peyronie’s disease)

It’s a connective tissue disorders characterized by the growth of non-elastic fibrous plaques in the soft tissue of the penis, causing pain, erectile dysfunction, loss of girth and shortening. A small quote of patients improve spontaneously, the 50% get worse with time and the rest is relatively stable. In the early stages the conservative therapy is effective. Surgical therapy is mandatory in the most advanced cases. Three are the main techniques used: 1) a corporoplasty; 2) plaque removal and substitution with a graft; 3) penile prosthesis.

 

SHORT PENIS

It’s commonly defined as an erectile penis measuring less than 14 cm. For other authors the deadline to define any penis as “short” is different. In most cases It represents a psychological more than an anatomic problem.

TECHNIQUES OF PENIS LENGTHENING

The penile lenthening and augmentation technique makes the penis longer by cutting ligaments that hold the penis inside the body gaining up to 2.5 – 3 cm. A further gain in length may be obtained by the use of WY flaps with a further gain of 3 cm. A mons pubis liposuction may represent a further improvement of the final penile appearance.

MONS PUBIS LIPOSUCTION, MINI-ABDOMINOIPLASTY AND ABDOMINOPLASTY

Removal of fat from the pubis is a typical indication to render the penis more prominent from the base of the pubis, especially in cases of obesity. Any weigth loss, aging or marked obesity cause a prominent or loose pubis. A liposuction or mini-abdominoplasty or complete abdominoplasty represent the most effective solutions to elevate the pubis.

PENILE PROSTHESES

Are indicated only in cases or erectile dysfunctions and not for aesthetic reasons only.

PENIS ENLARGEMENT

It’s indicated in people with really short penis.

I should be remembered that It’s difficult to obtain pleasant and stable effects with time.

In the past the use of non-absorbable substances (polymethyl-methacrylate and similar) has produced many long-lasting complications. Nowadays a lipostructure is the least dangerous procedure by injecting fat grafts in the subcutaneous layer. The maximum volume injectable is 5-10 mm with a resorption of the 50% in 3 months when another procedure is required. The use of injectable hyaluronic acid proposed by some Spanish authors can be also effective in selected cases for penis enlargement.