Ligamentotomy is a surgical excision of the suspensory ligament of the penis, which leads to an increase in the length of the organ. It is performed only according to indications, and the most important thing is that the length of the penis at the moment of excitement is less than 12 cm.
The surgeon can make an incision in the scrotum or along the pubis, but the first option is considered less dangerous. During rehabilitation, every day you have to wear an extender - a special device for actually lengthening the penis. The final results can only be assessed 6-10 months after the operation.
The price of ligamentotomy ranges from 330-2800 dollars and depends on the price policy of the clinic, services provided and supplying 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 cutting of the suspensory ligament. In almost every case, men notice an increase in the length of the penis by at least 2 cm, 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 the extender during the rehabilitation period - the organ stretches only after 6-10 months.
Indications for use
Ligamentotomy is performed at the request of a man, and the main indication for manipulation is the length of the penis up to 12 cm in the state of peak sexual excitement. This problem is most often associated with the anatomical characteristics of the structure of the congenital organ - the micropenis. But there are other direct indications for excision of the suspensory ligament:
- progressive cavernous fibrosis (the cavernous bodies of the penis are replaced by connective tissue);
- suffered injuries that reduced the length of the penis;
- diagnosed Klinefelter and Kallman syndromes of hereditary origin;
- irregular location of the opening of the urethra (hypospadia);
- complete or partial splitting of the upper wall of the urethra (epispadias);
- Peyronie's disease, which is a severe curvature of the penis.
Contraindications
Ligamentotomy has clear medical contraindications for:
- infectious diseases of the genitourinary system;
- the size of the penis is greater than 12 cm in the state of excitement;
- skin pathologies 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 the operation even if the length of the penis is 12 cm and it does not bring physiological satisfaction, while psychological satisfaction is at the appropriate level.
Infectious diseases and skin lesions are considered conditional contraindications. Doctors will first carry out therapy, achieve complete recovery or introduce a chronic form of pathology into a phase of stable remission, and only after that the person can be released for 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 can be less "remarkable". In order to achieve the desired effect, a man must strictly follow all the doctor's recommendations:
- undergo full preparation - taking tests, examination by cardiologist and andrologist, visit to psychotherapist and so on;
- treat the wound during the rehabilitation period;
- to refuse sexual intercourse for a certain period;
- regularly use an extender - a device for stretching the penis.
Ligamentotomy: cost
The price of the ligamentotomy operation 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.
Advantages and disadvantages of ligamentotomy surgery
Ligamentotomy surgery has its advantages:
- the safety of the procedure, because it is not about the reconstruction of the penis, but about its plastic surgery;
- use of local anesthesia instead of general anesthesia during surgery;
- minimum probability of complications and side effects;
- there is no need to implant supporting devices in the penis;
- the possibility of an immediate increase in the width of the penis during manipulation;
- durability of results.
But some experts are categorically against ligamentotomy, because it has many disadvantages: the price 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, a long recovery before achieving the desired result.
Preparation for penis enlargement with ligamentotomy
Before penis enlargement by ligamentotomy is prescribed, the patient must undergo preparation and first of all be examined to determine contraindications; the following is prescribed:
- general urinalysis, bacterial culture;
- biochemical and general blood tests;
- allergy test to determine the body's reaction to antibiotics;
- ultrasound examination of pelvic organs;
- electrocardiogram, blood pressure control;
- chest x-ray.
In addition, a man must visit a psychologist so that a specialist can identify mental abnormalities - they are an absolute contraindication for manipulation.
Also, within the preparatory period, the man is prescribed:
- stop drinking alcoholic beverages at least 24 hours before the planned intervention date;
- stop eating and drinking 6 hours before surgery;
- exclude all drugs from the group of anticoagulants 3 days before ligamentotomy;
- shave the groin area;
- take a shower in the morning before the intervention.
How is penis lengthening performed by ligamentotomy?
Penis lengthening during ligamentotomy is carried out according to a clear algorithm:
- The man was placed on the couch.
- The anesthesiologist is doing his job - giving spinal anesthesia.
- The patient's condition is monitored - whether there is nausea or vomiting, blood pressure is measured, 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.
- Stretch the penis with your fingers to the maximum possible length (individual indicator).
- The incision is sutured, and a sterile bandage is placed on the surgical wound.
Most often, the standard course of surgery is changed if it is necessary to increase the width of the penis at the same time. In addition, the doctor can use different types of ligament excision - through the pubis or the scrotum.
Excision in the scrotal area
Features of ligamentotomy by excision in the scrotal area:
- the surgeon cuts the upper part of the scrotum and immediately separates the soft tissue;
- After one incision, the doctor has access to the entire ligament apparatus;
- the strap ligament is crossed;
- the suspensory ligament is excised.
This method of manipulation is considered the safest, and has clear advantages:
- The doctor's working time is reduced to 10 minutes (in some cases - up to 20 minutes);
- no scar after complete rehabilitation;
- soft tissue trauma is minimized;
- After the operation, the patient practically does not feel pain.
Excision in the scrotal area made it possible to perform a ligamentotomy for those men who are overweight - the standard operation is not performed if there is a large amount of fatty tissue.
Dissection in the pubic area
This method is considered classic; the doctor makes an incision on the pubis, which makes his work easier - the field is opened for free isolation and excision of the suspensory ligament. But ligamentotomy in the pubic area has many disadvantages:
- even after complete rehabilitation, large scars remain on the pubis, which later turn into rough scars;
- soft tissues are seriously injured, and this prolongs the rehabilitation period;
- it is impossible to perform the operation in men with a large amount of fatty tissue;
- after the procedure, the penis cannot take the correct raised position at the moment of excitement due to compression of the tissue by the scar.
The operation to increase the length of the penis with dissection in the pubic area takes 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 - on the first days no more than 2 hours in a row, gradually increase this figure to 8 hours;
- you must refrain from sexual intercourse for at least 2 weeks;
- you must strictly follow the rules of personal hygiene to avoid infection;
- the patient should visit the doctor regularly to monitor recovery;
- change the dressing on the surgical wound three times a day.
It is strictly forbidden for a man to apply ointments, creams and any medicines not prescribed by a doctor to the seams. The patient should refrain from physical activity for 4 weeks, and then should be extremely moderate.
Possible complications
The most common complications after ligamentotomy are:
- changes in a man's sexual abilities - the surgeon is solely to blame;
- the presence of severe pain during the recovery period;
- swellings and hematomas in the perineal area, which disappear on their own 4-6 days after the operation;
- infection of the operative area;
- bleeding - the blame falls on the patient who does not follow 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 testicle and its appendages (orchiepididymitis) are possible.
Effect for patients
The patient can assess the final result of the ligamentotomy only 6-10 months after the operation, when the course of wearing the extender is completed 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 male body and the anatomical characteristics of the structure of the penis. But almost every patient claims that the quality of their sexual life has improved.
Ligamentotomy is the most effective method of increasing the length of the penis, which involves surgery and a long period of rehabilitation. If the patient strictly adheres to the doctor's recommendations and uses the extender correctly, the results will definitely be positive.