Male reproductive system diseases
Sexual Dysfunction and Infertility
Although, penis enlargement is a very common reason especially for young men to visit urologist-andrologist, and even a more common reason for searcing the Internet, the truth on a medical basis is that penile size is not an important factor for female orgasm, given the fact that 90% of the sensory nerve terminals, that trigger the sense of pleasure and the contractions of the muscles of the female perineum, which actually represent an orgasm, are located on the clitoris and in the first one centimetre of the vagina. Thus, even a 5cm long penis in erection can be fully sexually functional.
In fact, although many men are seeking medical help to get their penis longer and thicker, they really do not have any anatomical or functional problems. Generally speaking most of men, if asked, would wish they had a bigger penis, although at the same time they will admit that they have a satisfactory sexual life. However, some men present a psychological disorder that makes them have a negative view for the size of their penis. This disorder is called “penile dysmorphophobia” and is very stressing.
The condition may regard the size of their penis in the relaxed phase and it is then called “aesthetic dysmorphophobia”, or in the phase of erection and then it is called “functional dysmorphophobia”.Although it looks a bit strange, aesthetic dysmorphophobia is more frequent than functional dysmorphophobia. The disorder can be caused by one more psychologically traumatic events, such as the rejection of the man by one or more sexual companions due to the penis size, or there can be no obvious initial cause in the patient’s medical history.
Patients with this psychological disorder have frequently serious problems to create sexual relationships, due to shame and lack of self-confidence. Sometimes these negative feelings may cause even erectile dysfunction. On the contrary, patients with anatomical micropenis, which is a very rare condition compared to dysmorphophobia, may have a positive view for their personal image and a satisfactory sexual life. Apart from the poor sexual life, dysmorphophobics have an even more serious problem.
Their condition is very persistent and most of the times they do not accept the recommendation of the andrologist to seek psychiatric help. However, even if they do, their problem more frequently will not be solved. Thus, these people are ready to undergo any kind of medication or surgical “therapy” is proposed to them, or they find out on the Internet.
This makes them particularly vulnerable to penis enlargement “treatments”, which may in the best case be ineffective and in the worst dangerous. People that seek such solutions must particularly have in mind, that there is no quality control of the information unlimitedly provided on the Internet and therefore the effectiveness and mainly the safety of the proposed methods are not checked. The truth about the usually presented on the Internet pharmaceutical methods for penis enlargement, is that they do not really exist. That means, that they are completely ineffective and some times cause severe side effects.Also the use of devices, to stretch the relaxed penis for some hours daily, has not been proven to offer remarkable results.
These devices are really useful, after penis surgical operations for various reasons including the enlargement operations or the penile straightening operations in case of Peyronie’s disease. In these cases the postoperative occasional application of stretching for some months can eliminate the shrinkage, which occurs during healing procces of the surgical wound,restoring thus the initial length of the penis.
Surgery can increase both the length and the width of the penis. Many and various techniques are described, both in scientific articles, and on the Internet. Some of them are experimental and some could be also dangerous. The only scientifically documented, safe and acceptable technique for penis enlargement do not, in fact, add centimetres to the penis, but rather try to “dig out” a part of the already existing organ from the surrounding tissues. The operation is performed with general anaesthesia and its duration is 2-3 hours, depending on how many of the following stages will take place.
These stages are:
- Liposuction of the suprapubic area. It is easy and safe and it unburies a part of the penis from the surrounding fat. The more fat exists in the suprapubic region, the better the result.
- Resection of the levator of the penis. This levator is responsible for the upward inclination of the erect penis. Its resection “detaches” a section of the back of the penis, which is located within the body, from the pelvis bone and thus, the penis is mobilised and acquires some additional length. In order to avoid a symphysis reattachment, we place a small lipodermal implant between the bone and the back of the penis. This implant is taken by the region of the patient’s thigh and because it is his body part, we avoid complications that could possibly occur from the use of foreign materials. This procedure is safe. Sometimes, a minor instability of the erect penis is reported, however this does not cause problems.
- Performance of plastic surgery in order to relax the skin on the dorsal surface of the penis and attach the subcutaneous tissue to the periosteum of the pubic bone. It is thus secured, that there is no “pulling” or limitation of the penis mobilisation by the suprapubic skin, and also the effective “unburying” of the penis
- Performance of plastic surgery in order to relax the skin on the ventral surface of the penis, aiming to “transform” a part of the scrotum skin to penile skin. Thus, a part of the ventral surface of the penis is getting free from the scrotum. This step is not always necessary and is not performed, when a simultaneous lengthening and thickening of the penis has been selected.
- The application of stretching to the penis by using a special stretching device. This is applied eight weeks after the operation and for 3-6 months. The aim is to get back the all the obtained by our surgery additional centimetres of the penis length, which are possibly lost, due to postoperative shrinkage caused by the healing process.
- Increase of penis thickness. This can be achieved by two techniques:
a) By placing an implant acting as a “thick sheath” under the skin of the penis and attach it on the base of the penis. This implant can be obtained by the patient’s body and be a “lipodermal” implant taken from the buttocks or the belly. Alternatively an allogeneic implant can be used like pig collagen. The thickness of the implant is added to the diameter of the penis and, thus the overall diameter increases. This technique can be performed simultaneously with penis lengthening. Rare complications can be a partial or total necrosis of penile skin, or fibrosis and shrinkage of the implant. A “foreign” implant, on the other hand, could be infected with devastating results.
b)By the injection by special syringes, of various thick liquid materials under the skin of the penis. These materials can be fat coming from the liposuction of the suprapubic region during the first step of lengthening or hyaluronic acid. The use of liquid silicone, paraffin or other unknown materials can cause serious reactions in the skin of the penis, with devastating consequences and must be avoided. Patient’s fat after a proper processing and centrifugation is placed under the penis skin and is “molded” by the surgeon’s hands, so that it can be evenly distributed under the entire penis surface.
The penis is maintained stretched during the whole procedure, in order to achieve a uniform thickening result during the erection also. Use of patient’s fat helps avoiding complications that may be caused by foreign materials. Sometimes, if the patient wishes, the fat injection can be repeated after 6 months with local anaesthesia.The procedure of thickening of the penis can be performed without a simultaneous lengthening by local anaesthesia only.