Penile enhancement for patients with micropenis, exstrophy, or penile amputation

Résumé fourni par la source

ABSTRACT Introduction: Insufficient penis (IP) is defined as inadequate genital size for satisfactory sexual penetration, resulting in functional impairment and psychosocial consequences. Etiologies include congenital conditions (exstrophy–epispadias complex and micropenis) and acquired causes (traumatic amputation and penile cancer). While phalloplasty and penile enhancement techniques exist, their limitations necessitate alternative approaches. Materials and Methods: This prospective multicenter case series described the initial findings of total corpora mobilization (TCM) in patients ≥18 years with IP from penile neoplasia, trauma, or functional impairment at four referral centers. A standardized surgical protocol was performed by a single surgeon, involving ligament release, subperiosteal dissection with neurovascular preservation, and crural fixation. Outcomes included penile length, penetration ability, satisfaction, and complications. A narrative literature review contextualized TCM within existing reconstruction paradigms. Results: Patients achieved an average penile length increase from 3.1 cm to 8 cm, with improved appearance and functionality. All patients achieved penetration post-surgery, although two experienced difficulties due to obesity. Complications were limited to graft failure in two cases, corrected with re-grafting. Conclusion: TCM emerges as a promising technique for IP management, demonstrating reproducible anatomical restoration and functional recovery. While preliminary results are encouraging, this series is still preliminary, with few operated patients and a very short follow-up period.

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