Ligamentotomy is a surgical procedure for excision of the suspensory ligament of the penis, which leads to an increase in the length of the organ. It is carried out only according to indications and the main thing is that the length of the penis is less than 12 cm at the time of arousal.
The surgeon can make an incision in the scrotum or along the pubis, but the first option is considered less dangerous. During rehabilitation, you need to wear an extender every day - a special device for, in fact, lengthening the penis. The final results can only be assessed 6-10 months after surgery.
The cost of ligamentotomy ranges from $330-2800 and depends on the pricing policy of the clinic, the services provided and the provision of the man with an extender.
Ligamentotomy - what is it?
Ligamentotomy is an operation to increase the length of the penis, the essence of which is the excision of the suspensory ligament. In almost every case, men note an increase in the penis by at least 2 cm in length, but such surgical intervention is not suitable for everyone - there are clear contraindications.
The operation itself does not lead to an immediate increase in the length of the penis; the patient must constantly use an extender during the rehabilitation period - the organ is stretched only after 6-10 months.
Indications for use
Ligamentotomy is performed at the request of the man; the main indication for manipulation is the length of the penis up to 12 cm in a state of peak sexual arousal. This problem is most often associated with the anatomical features of the structure of a congenital organ - the micropenis. But there are other direct indications for excision of the suspensory ligament:
- progressive cavernous fibrosis (the cavernous corpuscles of the penis are replaced by connective tissue);
- suffered injuries that led to a decrease in the length of the penis;
- diagnosed Klinefelter and Kallman syndromes of hereditary origin;
- incorrect location of the urethral opening (hypospadias);
- complete or partial splitting of the upper wall of the urethra (epispadias);
- Peyronie's disease, which is a severe curvature of the penis.
Ligamentotomy has clear medical contraindications for:
- infectious diseases of the genitourinary system;
- penis size is more than 12 cm in a state of excitement;
- pathologies of the skin with localization of symptoms in the perineum, groin;
- instability of the psycho-emotional background (this condition must be confirmed by a psychotherapist).
Surgeons refuse to perform an operation even if the length of the penis is 12 cm and does not bring physiological satisfaction, while psychological satisfaction is at the proper level.
Infectious diseases and skin lesions are considered conditional contraindications. Doctors will first carry out a course of therapy, achieve complete recovery or introduce the chronic form of the pathology into a stage of stable remission, and only after that can the man be allowed to undergo surgery.
What results can you expect before and after ligamentotomy?
Before and after ligamentotomy, the penis looks radically different - usually there is an increase in its size by 3-5 cm, but the result may be less "outstanding". To achieve the desired effect, a man must strictly follow all the doctors’ recommendations:
- undergo full preparation - taking tests, examination by a cardiologist and andrologist, visiting a psychotherapist, and so on;
- treat the wound during the rehabilitation period;
- refuse sexual intercourse for a certain period;
- regularly use an extender - a device for stretching the penis.
The price of ligamentotomy surgery is quite high, and this is a significant disadvantage of the method of increasing the length of the penis, but it is also considered the most effective; in some clinics they even guarantee the maximum result.
Pros and cons of ligamentotomy surgery
The ligamentotomy operation has its advantages:
- the safety of the procedure, because it is not reconstruction of the penis, but its plastic surgery;
- the use of local anesthesia rather than general anesthesia during the operation;
- minimal likelihood of complications and side effects;
- no need to implant supporting devices into the penis;
- the ability to immediately increase the width of the penis during the manipulation;
- durability of the result.
But some experts are categorically against ligamentotomy, because it has a lot of disadvantages: the cost of the surgeon’s work is too high, the need to abstain from sexual relations for several weeks (sometimes months), a high probability of bleeding already in the rehabilitation period, long recovery before obtaining the desired result.
Preparation for penis enlargement with ligamentotomy
Before penile enlargement using ligamentotomy is prescribed, the patient must undergo preparation and first of all be examined to identify contraindications; the following are prescribed:
- general urinalysis, bacterial culture;
- biochemical and general blood tests;
- allergy test to determine the body's reaction to antibiotics;
- ultrasound examination of the pelvic organs;
- electrocardiogram, blood pressure control;
- chest x-ray.
In addition, a man must visit a psychologist so that the specialist can identify mental abnormalities - they are an absolute contraindication to manipulation.
Also, as part of the preparatory period, a man is prescribed:
- stop drinking alcoholic beverages at least 24 hours before the scheduled date of intervention;
- stop eating and drinking 6 hours before surgery;
- exclude any medications from the anticoagulant group 3 days before ligamentotomy;
- shave the groin area;
- take a shower in the morning before the intervention.
How is penis lengthening performed with ligamentotomy?
Penis lengthening during ligamentotomy is carried out according to a clear algorithm:
- The man is placed on the couch.
- The anesthesiologist does his job - gives spinal anesthesia.
- The patient's condition is monitored - whether there is nausea or vomiting, blood pressure is measured, and sensitivity in the area below the lumbar region is checked.
- The surgeon makes an incision and feels the connective ligament with his fingers and immediately cuts it with a scalpel.
- Use your fingers to stretch the penis to the maximum possible length (individual indicator).
- The incision is sutured, and a sterile bandage is applied to the surgical wound.
Most often, the standard course of the operation changes if a simultaneous increase in the width of the penis is required. In addition, the doctor can use different types of excision of the ligament - through the pubis or scrotum.
Excision in the scrotal area
Features of ligamentotomy by excision in the scrotum area:
- the surgeon cuts the upper part of the seminal sac and immediately pushes the soft tissue apart;
- After one incision, the doctor has access to the entire ligamentous apparatus;
- the sling ligament is crossed;
- the suspensory ligament is excised.
This method of manipulation is considered the safest, and it also has clear advantages:
- The doctor’s work time is reduced to 10 minutes (in some cases – up to 20 minutes);
- there is no scar after complete rehabilitation;
- soft tissue trauma is minimized;
- After the operation, the patient feels virtually no pain.
Excision in the scrotal area made it possible to perform ligamentotomy for those men who are overweight - a standard operation is not performed if there is a large amount of adipose tissue.
Dissection in the pubic area
This method is considered classic; the doctor makes an incision on the pubis, which makes his work easier - a field opens for free isolation and excision of the suspensory ligament. But ligamentotomy in the pubic area has a lot of disadvantages:
- even after complete rehabilitation, large scars remain on the pubis, which later transform into rough scars;
- soft tissues are severely injured, and this increases the rehabilitation period;
- it is impossible to perform the operation on men with a large amount of adipose tissue;
- after the procedure, the penis cannot take the exact upward position at the moment of arousal due to compression of the tissues by the scar.
The operation to increase the length of the penis with a dissection in the pubic area lasts at least 60 minutes.
Recovery after endoscopic ligamentotomy
Endoscopic ligamentotomy involves a long period of rehabilitation, during which:
- wearing an extender - a special device that can be worn only on the second day after surgery;
- compliance with the duration of wearing the extender - the first days no more than 2 hours in a row, gradually increase this figure to 8 hours;
- you need to abstain from sexual intercourse for at least 2 weeks;
- you should strictly observe the rules of personal hygiene to avoid infection;
- the patient should regularly visit the doctor to monitor recovery;
- change the dressing on the surgical wound three times a day.
A man is strictly prohibited from applying ointments, creams and any medications not prescribed by the attending physician to the stitches. The patient should refrain from physical activity for 4 weeks, then it should be extremely moderate.
The most common complications after ligamentotomy are:
- changes in a man’s sexual abilities – the surgeon is solely to blame for this;
- the presence of severe pain during the recovery period;
- swelling and hematomas in the perineal area, which disappear on their own 4-6 days after surgery;
- infection of the operating area;
- bleeding - the blame falls on the patient who does not comply with the rules of rehabilitation.
If an infectious agent is introduced into the surgical wound, then the process of suppuration, the formation of adhesions, and the progression of inflammation in the tissues of the testicles and its appendages (orchiepididymitis) are possible.
Effect for patients
The patient can evaluate the final result of ligamentotomy only 6-10 months after the operation, when the course of wearing the extender ends and the increase reaches its maximum. Usually the length of the penis increases by 2-7 cm, it all depends on the individual characteristics of the man’s body and the anatomical features of the structure of the penis. But almost every patient claims an improvement in the quality of sexual life.
Ligamentotomy is the most effective method of increasing the length of the penis, which involves surgery and a long rehabilitation period. If the patient strictly follows the doctor’s recommendations and uses the extender correctly, the results will definitely be positive.