Ligamentotomy is a surgical procedure to remove the suspensory ligament of the penis, resulting in lengthening of the organ. It is carried out only according to indications and the main thing is that the length of the penis at the time of arousal is less than 12 cm.
The surgeon can make an incision in the scrotum or along the pubic bone, but the first option is considered less dangerous. During rehabilitation, you will have to wear an extender every day - a special device that actually lengthens the penis. The final result can only be assessed 6-10 months after the operation.
The cost of a ligamentotomy ranges from $330 to $2, 800 and depends on the clinic's pricing policy, the services provided and whether the man is equipped with an extender.
Ligamentotomy – what is it?
Ligamentotomy is an operation to enlarge the penis, the essence of which is the removal of the suspensory ligament. In almost all cases, men notice an enlargement of the penis of at least 2 cm. However, such a surgical procedure is not suitable for everyone - there are clear contraindications.
The surgery itself does not result in immediate penile lengthening; the patient must constantly use an extender during the rehabilitation period - the organ is stretched only after 6-10 months.
Instructions for use
The ligamentotomy is performed at the man's request; The main indication for manipulation is penis length up to 12 cm in a state of maximum sexual excitement. This problem is most often associated with the anatomical features of the structure of a congenital organ - the micropenis. But there are also other direct indications for removing the suspensory ligament:
- progressive cavernous fibrosis (the cavernous blood cells of the penis are replaced by connective tissue);
- sustained injuries that resulted in penile shortening;
- diagnosed Klinefelter and Kallman syndromes of hereditary origin;
- incorrect position 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.
Contraindications
Ligamentotomy has clear medical contraindications for:
- Infectious diseases of the urogenital system;
- Penis size is more than 12 cm when aroused;
- 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 surgery even if the penis length is 12 cm and does not bring physiological satisfaction, while psychological satisfaction is at the right level.
Infectious diseases and skin lesions are considered conditional contraindications. Doctors will first conduct therapy, achieve complete recovery or transfer the chronic form of pathology to a stage of stable remission, and only after that the man can be allowed to undergo surgery.
What results can you expect before and after ligamentotomy?
Before and after ligamentotomy, the penis looks completely different - usually there is an increase of 3-5 cm, but the result may be less "excellent". To achieve the desired effect, a man must follow all the recommendations of doctorsstrictly follow:
- undergo comprehensive preparation - take tests, undergo an examination by a cardiologist and andrologist, visit a psychotherapist, etc. ;
- treat the wound during the rehabilitation period;
- refuse sexual intercourse for a certain period of time;
- Regularly use an extender - a device for stretching the penis.
Ligamentotomy: price
The price of ligamentotomy surgery is quite high, which is a significant disadvantage of the penis lengthening method, but it is also considered the most effective; In some clinics the maximum result is even guaranteed.
Advantages and disadvantages of ligamentotomy surgery
Ligamentotomy surgery has its advantages:
- the safety of the procedure, since it is not a reconstruction of the penis but a plastic surgery;
- the use of local anesthesia instead of general anesthesia during surgery;
- minimal likelihood of complications and side effects;
- no need to implant supportive devices into the penis;
- the ability to instantly increase the width of the penis during manipulation;
- durability of the result.
However, some experts categorically reject ligamentotomy, as it entails many disadvantages: the surgeon's workload 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 the desired result is achieved.
Preparation for penis enlargement with ligamentotomy
Before penis enlargement using ligamentotomy is prescribed, the patient must be prepared and first examined for contraindications; The following is prescribed:
- general urinalysis, bacterial culture;
- biochemical and general blood tests;
- Allergy test to determine the body's response to antibiotics;
- Ultrasound examination of the pelvic organs;
- electrocardiogram, blood pressure control;
- Chest x-ray.
In addition, a man needs to see a psychologist so that he can identify psychological 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 procedure date.
- Stop eating and drinking 6 hours before surgery;
- 3 days before ligamentotomy exclude all drugs from the anticoagulant group;
- shave the groin area;
- Shower in the morning before the procedure.
How is penis lengthening performed using ligamentotomy?
Penis lengthening during ligamentotomy occurs according to a clear algorithm:
- The man is placed on the couch.
- The anesthesiologist is doing his job - he is performing 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 spine is checked.
- The surgeon makes an incision, feels the binding 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 the operation changes when it is necessary to simultaneously increase the width of the penis. In addition, the doctor can use different types of ligament removal - through the pubic bone or the scrotum.
Excision in the scrotal area
Features of ligamentotomy by excision in the scrotum area:
- The surgeon cuts through the upper part of the sperm sac and immediately pushes the soft tissue apart.
- After an incision, the doctor has access to the entire ligament apparatus;
- the noose is crossed;
- The suspensory ligament is cut out.
This method of manipulation is considered the safest and also has clear advantages:
- The doctor's working time is reduced to 10 minutes (in some cases up to 20 minutes);
- after complete rehabilitation, no scar remains;
- Soft tissue trauma is minimized;
- After the operation, the patient feels almost no pain.
Excision in the scrotal area made it possible to perform a ligamentotomy in obese men - a standard operation is not performed when there is a lot of fatty tissue.
Dissection in the pubic area
This method is considered classic: the doctor makes an incision on the pubic bone, which makes his work easier - a field opens for free isolation and removal of the suspensory ligament. But ligamentotomy in the pubic area has many disadvantages:
- Even after complete rehabilitation, large scars remain on the pubic bone, which later turn into rough scars;
- Soft tissues are seriously injured, which increases the rehabilitation period;
- it is impossible to perform the operation on men with a lot of fatty tissue;
- After the procedure, the penis cannot assume the exact upward position at the moment of excitement due to the compression of the tissue by the scar.
The penis enlargement operation with dissection of the pubic area takes at least 60 minutes.
Recovery after endoscopic ligamentotomy
Endoscopic ligamentotomy requires a long rehabilitation period during which:
- Wearing an extender – a special device that can only be worn 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 increasing this number to 8 hours;
- You must abstain from sexual intercourse for at least 2 weeks;
- You should strictly follow the rules of personal hygiene to avoid infections.
- the patient should visit the doctor regularly to monitor recovery;
- Change the surgical wound dressing three times a day.
A man is strictly forbidden to apply ointments, creams and other medications to the seams that have not been prescribed by the attending physician. The patient should avoid physical activity for 4 weeks, after which it should be extremely moderate.
Possible complications
The most common complications after a ligamentotomy are:
- Changes in a man's sexual abilities - this is solely the responsibility of the surgeon;
- the presence of severe pain during the recovery period;
- Swelling and hematomas in the perineal area that disappear on their own 4-6 days after surgery;
- infection of the surgical area;
- Bleeding - the blame lies with the patient who does not follow the rules of rehabilitation.
When an infectious pathogen is introduced into the surgical wound, the process of suppuration, the formation of adhesions and the progression of inflammation in the tissue of the testicles and their appendages (orchiepididymitis) is possible.
Effect for patients
The patient can only judge the final result of the ligamentotomy 6-10 months after the operation, when the period of wearing the extender ends and the enlargement reaches its maximum. Normally, 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 penis lengthening, which requires surgical intervention 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.