Circumferential dissection of deep fascia as ancillary technique in circumcision: is it possible to correct phimosis increasing penis size?

Abstract

Background Phimosis is the inability to retract the preputium downward over the glans penis. Despite the various techniques of preputial plasty described in literature, the most performed surgical treatment is still the conventional circumcision. Methods In this paper we retrospectively reviewed data of a homogeneous population of 36 consecutive adult patients who underwent phimosis correction by circumcsion with dissection of the Deep Fascia. Patients were followed up by one independent plastic surgeon that measured penis length and circumference in nonerected state preoperatively and at 6 month time postoperatively. Results The Wilcoxon Signed Rank Test showed a significant (p < 0.0001) difference between the two groups both in terms of length and circumference. Conclusions In conclusion, the ancillary technique we described leads to an increase of penis size, is safe and easy to perform and does not increase significantly operative time nor complication rate to the conventional procedure.

Phimosis in adults: narrative review of the current treatments

“…Figure 1 provides a diagram on the flow of information through the different phases of this systematic review according to the PRISMA criteria [15]. Fourteen studies (46,7%) were classified as case-series [4], [16][17][18][19][20][21][22][23][24][25][26][27][28] and 6 studies (20,0%) were classified as case-comparative series, in both cases with a retrospective evaluation of the reported data [29][30][31][32][33][34]. Finally, 10 (33,3 %) were prospective case-control studies [6], [35][36][37][38][39][40][41][42][43].…”

“…The cost of surgery to the 2 groups was similar [35]. Pagano C et al proposed a dissection of deep fascia after conventional circumcision to improve length and circumference of the penis in a retrospective study on 36 male patients [20]. A two-step surgical procedure was described: the first step consisted in a conventional circumcision; in the second step the skin of the penis body was retracted to the base showing ventrally the presence of the areolar tissue and Buck's Fascia and adherent bridles were identified and bluntly dissected.…”

“…Platelet-rich plasma (PRP) [Casabona F et al,20] Reduction/disappearance of symptoms and/or of lichen sclerosus Risk of malignant disease (actually no study demonstrates that PRP promotes hyperplasia, carcinogenesis, or tumor growth)…”

“…A two-step surgical procedure was described: the first step consisted in a conventional circumcision; in the second step the skin of the penis body was retracted to the base showing ventrally the presence of the areolar tissue and Buck's Fascia and adherent bridles were identified and bluntly dissected. A relaxation of the adherences of the Buck's fascia of penis and a decompression of the corpora cavernosa were obtained, causing an improvement of penile length and circumference [20].…”

Mondor’s disease as a complication in breast surgery in a male patient. The first ever reported case in literature

“…In fact vessel-wall can be damaged by intense sexual activity, a prolonged erection can lead to blood stasis and hypercoagulation can be related to infections, trauma, surgery or occult tumors of the genital sphere [ 4 , 5 , 20–23 ].…”