Ligamentotomy is a surgical procedure for cutting the suspensory ligaments 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 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 will wear an extender every day - a special device to actually lengthen the penis. The final results can only be assessed 6-10 months after the operation.
The cost of ligamentotomy ranges from $330-2800 and depends on the clinic's pricing policy, the services provided and the man's provision of 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 all cases, men notice 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 husband's request; the main indication for manipulation is the length of the penis up to 12 cm in a state of maximum sexual arousal. This problem is most often associated with the anatomical features of the structure of a congenital organ - micropenis. But there are other direct indications for excision of the suspensory ligament:
- progressive cavernous fibrosis (cavernous blood cells 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 (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;
- penis size is more than 12 cm in a state of tension;
- 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 give physiological satisfaction, while psychological satisfaction is at the right 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 in 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 radically different - usually there is an increase in its size by 3-5 cm, but the result can be less "excellent". To achieve the desired effect, a man must strictly follow all the doctors' recommendations:
- undergo full preparation - take tests, examination by a cardiologist and andrologist, visit a psychotherapist and so on;
- treat the wound during the rehabilitation period;
- refuse intercourse for a certain period;
- regularly use an extender - a device to stretch the penis.
Ligamentotomy: price
The price of 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
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 instead of general anesthesia during surgery;
- minimal likelihood of complications and side effects;
- no need to implant support devices in the penis;
- the ability to immediately increase the width of the penis during the manipulation;
- the durability of the result.
But some experts are categorically against ligamentotomy because it has many 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, longrestitution before achieving the desired result.
Preparation for penis enlargement with ligamentotomy
Before penis enlargement by means of ligamentotomy is prescribed, the patient must undergo preparation and, first of all, be examined to identify 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 the pelvic organs;
- electrocardiogram, blood pressure control;
- X-ray of thorax.
In addition, a man must visit a psychologist so that the specialist can identify mental abnormalities - they are an absolute contraindication to manipulation.
As part of the preparatory period, a man is also prescribed:
- stop drinking alcoholic beverages at least 24 hours before the scheduled date of intervention;
- stop eating and drinking 6 hours before the operation;
- exclude any medication from the anticoagulant group 3 days before ligamentotomy;
- shave the groin area;
- shower in the morning before the procedure.
How is penile lengthening performed with ligamentotomy?
Penis lengthening during ligamentotomy is performed according to a clear algorithm:
- The man is placed on the sofa.
- 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 lower back is checked.
- The surgeon makes an incision and feels the 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 is changed if a simultaneous increase in the width of the penis is required. In addition, the doctor can use different types of incision of the ligament - through the pubic bone or the scrotum.
Excision in the scrotal area
Functions of ligamentotomy by excision in the scrotum:
- the surgeon cuts the upper part of the scrotum and immediately pushes the soft tissue apart;
- After an incision, the doctor has access to the entire ligament apparatus;
- the sling is crossed;
- the suspensory ligament is excised.
This method of manipulation is considered the safest, and it also has clear advantages:
- The doctor's working 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 obese - a standard operation is not performed if there is a large amount of adipose tissue.
Dissection of the pubic bone
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 excision of the suspensory ligament. But ligamentotomy in the pubic region has many disadvantages:
- even after complete rehabilitation, large scars remain on the pubis, which later turn into rough scars;
- soft tissue is seriously 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 the 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 the operation;
- compliance with the duration of wearing the extender - the first days no more than 2 hours in a row, gradually increase this number to 8 hours;
- you must abstain from intercourse for at least 2 weeks;
- you should strictly observe 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.
A man is strictly forbidden to apply ointments, creams and medicines not prescribed by the attending physician to the stitches. The patient must refrain from physical activity for 4 weeks, after which it must 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 for this;
- the presence of severe pain during the recovery period;
- swelling and hematomas in the perineal area, which disappear by themselves 4-6 days after the operation;
- infection of the surgical site;
- bleeding - the blame lies with the patient who does not comply with the rules of rehabilitation.
If an infectious agent is introduced into the surgical wound, 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 penis structure. But almost every patient claims an improvement in the quality of sexual life.
Ligamentotomy is the most effective method to increase 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.