A comparative study on two kinds of surgical procedures of penile corpora cavernosa augmentation

Penile augmentation surgery is still a controversial issue because of the uncertain indication, the possibility of severe complications and a variety of surgical techniques. The purpose of this study is to provide two surgical procedures of penile corpora cavernosa augmentation and to investigate its effect by implanting autogenous saphenous vein grafts or expanded polytetrafluoroethylene (ePTFE) vessel patches.

Between January 2001 and December 2005, 20 patients underwent surgeries in which bilateral longitudinal incisions were placed on the tunica albuginea and the penile corpora cavernosa were extended by means of implantation of saphenous grafts or PTFE artificial vessel patches. The patients included in this study presented either with congenital idiopathic micropenis or normal penile length and perimeter (dysmorphophobia). Before the operation, the penile length and perimeter in the flaccid and erectile states were as follows: flaccid length 2.5-7.5 cm and flaccid perimeter 3.0-7.5 cm; erectile length 4.9-10.5 cm and erectile perimeter 4.5-10.0 cm.

Immediately after surgery, the penile corpus circumferential measurements (on table), showed remarkable increases which were 1.0-2.3 cm and 1.5-3.0 cm in the flaccid and erectile states, respectively; then, at 12 months to 5 years' follow-up, these girth gains had reduced by 0.5-1 cm in some cases. All cases in the two groups obtained satisfactory surgical results with satisfactory erection and no serious complications, such as infection and fistula. In 20 cases, 17 married cases resumed regular and satisfactory sexual activities 1 month after the operation without any functional limitation.

The two kinds of surgical procedures for augmenting penile corpora cavernosa were proved to be effective and reliable, with few complications. Both saphenous grafts and ePTFE artificial vessel patches are excellent materials for reconstructing the tunica albuginea. These augmenting phalloplasties can not only be used for patients with micropenis, but also applied to satisfy the cosmetic and functional requests of patients with normal penile length and perimeter. However, the long-term outcomes of these surgical procedures need a further, detailed follow-up study.