Original Technique for Penile Girth Augmentation Through Porcine Dermal Acellular Grafts: Results in a 69-Patient Series

Abstract

Introduction. 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. Aims. The aim of this study is to describe an innovative surgical technique for penile girth augmentation with porcine dermal acellular grafts, through a small transverse incision at the penile base, along the penopubic junction. Methods. Between 2000 and 2009, 104 patients were referred to our institution for penile enhancement. After a preoperative psychosexual consultation and a general medical assessment, 69 patients were deemed suitable good candidates for surgery. The average penis circumference was measured at the mid-length of the penis and was 8.1cm (5.4-10.7cm) and 10.8cm (6.5-15.8cm) during flaccidity and erection, respectively. All patients received penile augmentation with porcine dermal acellular grafts. Main Outcome Measures. Results evaluation of an innovative technique for penile girth augmentation through exogenous porcine grafts and small penobubic incision. Results. Postoperative measurements were performed at 6 and 12 months. At the 1-year follow-up, the average penis circumference was 11.3cm (8.2-13.2cm, 3.1cm mean increase) during flaccidity and 13.2cm (8.8-14.5cm, 2.4cm 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. Conclusion. Penile girth enlargement with acellular dermal matrix grafts has several advantages over augmentation with autogenous dermis-fat grafts: the elimination of donor site morbidity and a significantly shorter operation time. With this approach, through a short dorsal incision at the base of the penis, the scar is concealed in a crease covered by pubic hair and thus hardly visible. © 2012 International Society for Sexual Medicine.