A surgical method to increase glans size when placing a penile implant

What is it about?

This paper reports a clinical series evaluating a venous ligation technique performed during penile prosthesis implantation to prevent or reverse postoperative glans shrinkage and coldness and to enhance glanular fullness. Methods Population and procedure Consecutive men receiving penile implants were divided into an enhancing group (implant plus selective ligation of the retrocoronal plexus, deep dorsal vein, and cavernosal veins) and a control group (implant only). Measurements included glenoid circumference and radius (measured manually and on X-ray), operative time, and patient satisfaction. An acupuncture‑assisted local anesthesia protocol was used in many cases. Key findings Anatomic and functional outcomes The enhancing group showed larger postoperative glanular circumference and radius at 1 day and 1 year than controls. Patient satisfaction was higher in the venous‑ligation .group; complaints of cold glans were reduced. Operative tradeoffs The venous‑ligation procedure increased operative time but produced measurable glans enhancement. Clinical implications The technique offers a reconstructive option to mitigate glans shrinkage and coldness associated with penile implants. Patient selection and surgical skill are important: careful dissection, avoidance of excessive thermal injury, and awareness of prior fibrosis or embolic material are essential. Limitations Small, nonrandomized series from a single center; measurement variability between manual and radiographic methods; longer and larger studies needed to confirm durability and safety. Bottom line Selective venous ligation during penile prosthesis implantation appears to enhance glans size and patient satisfaction in this series; however, broader validation is required before routine adoption.

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Photo by Europeana on Unsplash

Photo by Europeana on Unsplash

Why is it important?

This study addresses a common and distressing postoperative problem after penile prosthesis implantation: glans shrinkage and coldness. By describing a targeted venous ligation technique that increased glanular circumference and radius and improved patient satisfaction, it offers a practical surgical strategy to preserve or restore penile appearance and sensation.

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