ABSTRACT
This study aimed to explore whether and how anti-lysyl oxidase (anti-LOX) combined with a vacuum device (VD) could promote penile lengthening and to evaluate the effect on erectile function. This study was performed on four groups of adult rats: control, anti-LOX, VD (negative pressure value of -300 mmHg), and anti-LOX + VD. Penile length was measured by a modified VD method and verified on exposed length data. Intracavernous pressure (ICP) and maximum ICP/mean arterial pressure (MAP) ratio were recorded to assess erectile function. For corpus cavernosum, LOX activity and concentrations of pyridinoline, desmosine, hydroxyproline, and elastin were analyzed; transmission electron microscope and Hart's elastin staining were performed to monitor microstructural changes. Anti-LOX and VD significantly lengthened the penis by 10.8% (3.75 mm) and 8.2% (2.48 mm) compared with the control group, respectively, while anti-LOX + VD achieved the longest penile size (40.58 ± 0.40 mm) which was 17.4% longer than the control group (34.58 ± 0.54 mm). After 1-week washout, no penile retraction was observed. Meanwhile, exposed penile length data confirmed that the penis in the anti-LOX + VD group was also significantly longer. Anti-LOX inhibited LOX activity to reduce pyridinoline level, which led the penile tunica albuginea remodeling. However, it had no effect on hydroxyproline, desmosine, and elastin levels. Moreover, anti-LOX had no impact on erectile function, which was determined by ICP and ICP/MAP ratio. These results suggest that anti-LOX elongates the penis by reducing pyridinoline, which induces tunica albuginea remodeling. This lengthening effect was more obvious when combined with a VD. All procedures had no impact on erectile function.
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Objective To improve the quality of life in patients with early penile carcinoma (T1N0M0) after partial excision of penile. Methods The clinical data of 21 patients with early penile carcinoma who were treated with partial excision of penile combined with penile lengthening surgery were retrospectively analyzed. Results The patients were followed up for 8 months to 5 years. None of patients had recurrence, and there were no external urethral stenosis and postoperative infection. The length of penile at extension state before surgery was 7.6-11.7 (8.3 ± 1.8) cm, and after surgery was 6.3-10.5 (7.4 ± 1.4) cm. All the patients were able to urinate in a standing position, 11 cases had normal sexual function, and 6 cases could complete after drug and psychological guidance. Conclusions Partial excision of penile combined with penile lengthening surgery is an effective treatment in patients with early penile carcinoma. It can significantly improve the patients' quality of life, and is an effective and feasible treatment method.
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Objective To evaluate the effectiveness and safety of autologous granular fat graft applied for penile lengthening and augmentation.Methods After all the superficial ligment and 1/3-2/ 3 part of the deep suspensory-ligament had been cut off for penile lengthening,local pedicaled fasciaadipose flap was designed to fill the depression,the pre-centrifuged autologous granular fat was injected into the space beneath Buck's fascia for penile augmentation.Normal length,pulling penis length,diameter,circumference and complications were evaluated.Results 34 cases were performed and followed up for 3-18 months,both ideal length and diameter increase of penis were achieved.The differences of nomal length,pulling-length,the diameter and circumference were (2.8±0.1) cm,(2.1±0.2) cm,(0.9 ± 0.1) cm,(2.8 ± 0.1) cm,respectively.The common complications included poor wound healing in 4 cases,preputial edema and subcutaneous scleroma in 8 cases for 3 months.Conclusions Autologous granular fat graft for penile augmentation during the lengthening surgery is a reliable and effective method and easy procedure.Detail processing can decrease the complications.
ABSTRACT
ObjectiveTo introduce a new procedure of penile lengthening which yields satisfactory outcomes and avoids persistent postoperative hydrophallus with the results of fresh body researches.MethodsIndirect intralymphatic injection and routine H-E staining were used to investigate the ramification of lymphatics of penis on fresh bodies.We found that the lymphatic return of penis was primarily mediated by dorsal and bilateral superficial lymph vessels,which converged dorsally at the root of penis and then ramified into the superior region of pubic symphysis and bilateral inguinal grooves.However,most previous incisions were done at the converging region of lymph vessels at the dorsal root of penis.It blocked most lymphatic return.Our modified method avoided interruption of lymph vessels in the converging region.Based on the results of the above investigations,the operative incision at the root of penis was shifted upward by 1.5 cm,and then the lengthened cavernous body of penis was covered by scrotal flap.ResultsEighty patients who accepted the new method achieved satisfactory outcomes.Postoperative hydrophallous decreased gradually from the 3rd day and vanished basically on the 6-7 day.ConclusionsOur modified procedure of penile lengthening reduces the damage of these vessels.Consequently,postoperative hydrophallus resolves fast and the new procedure yields high success rates,sound appearance and sensation of penis.Therefore,the new procedure is an ideal option for surgenons in clinical practice.