Trauma, Gender Reassignment, and Penile Augmentation

Abstract

Introduction Penile trauma is common with standard management options. Gender reassignment techniques are rapidly changing and penile augmentation remains a controversial topic. Consequently, there is need for a state-of-the-art information in this area. Aim This study aims to develop an evidence-based state-of-the-art consensus report on the management of penile trauma, gender, reassignment and penile augmentation. Methods The study provides state-of-the-art knowledge regarding the prevalence, etiology, medical and surgical management of penile trauma, gender reassignment and penile augmentation, representing the opinion of leading experts developed in a consensus process over a 2-year period. Main Outcome Measures Expert opinion was based on grading of evidence-based medical literature, widespread internal committee discussion, public presentation, and debate. Conclusions Penile fracture should be managed surgically. Information should be readily available to patients to help them decide the surgical technique desired for gender reassignment and to justify any form of penile augmentation.

Sexual function outcomes following fracture of the penis.

“…6 Immediate surgical repair is now the standard of care and is superior to a non-operative management due to excellent long term outcomes. [7][8][9] Data regarding sexual function following fracture of the penis is lacking. In a series of men presenting with penile fracture, we describe the long-term potency and overall sexual function following prompt surgical repair.…”

Is V–Y plasty necessary for penile lengthening? Girth enhancement and increased length solely through circumcision: description of a novel technique

“…In cases of dysmorphophobic patients who request penile augmentation, any type of surgery carries the risk of failure with potentially suboptimal results and unsatisfied patients. [3][4][5] Given that these males often have an unrealistic perception of their penile size, their expectations from the surgical outcome are also often unrealistic. These individuals should be discouraged from any surgical intervention and should be evaluated psychologically before any operation.…”

“…As reported by some authors, another point of skepticism regarding ligamentolysis is the shortening of a preoperatively normal penis. [3][4][5] This is caused primarily by the postoperative reattachment of the penile shaft to the pubis. To overcome this condition, the dermalfat pad was interposed in the pubic-penile space and penile weights and vacuum devices were applied.…”

“…To overcome this condition, the dermalfat pad was interposed in the pubic-penile space and penile weights and vacuum devices were applied. 4 Others proposed the insertion of a silicon buffer. 12 In our opinion, the penis extender device for penile traction is a preferable option because of its relatively low cost (approximately J100), its adjustability to any penile size, its ease in wear and the fact that high motivation is not a prerequisite for its success.…”

“…3,4 Moreover, the reported satisfaction rates are often poor, which is most likely because the formation of even small hypertrophic scars or keloids for these patients can reduce their inclination for surgery. Therefore, detailed counseling regarding the postoperative results and surgical complications is of utmost importance.…”