Complications of Genital Enlargement Surgery

Abstract

Introduction The objective of genital enlargement surgery is to increase length and/or girth for cosmetic reasons; however, newer techniques have been recently reported to be associated with only minor complications in a small percentage of patients. Aim We aim to report the severe complications of penile augmentation surgery seen at a referral center and describe their subsequent management. Methods Institutional review board approval was obtained. We reviewed our prospectively collected database for all patients who presented with complications of genital enlargement surgery from 2002–2016. Main Outcome Measure Interventions following complications of genital enlargement surgery. Results 11 Patients were identified. Mean age was 47 (21–77) years. Prior procedures included subcutaneous injection of silicone outside a medical setting, girth enhancement procedures involving the subcutaneous placement or injection of substances including fat, other substances, or subcutaneous silicone implants. All patients who underwent subcutaneous penile implant underwent removal prior to presentation. Adverse changes included sexually disabling penile deformity and severe shortening, curvature, edema, subcutaneous masses, infection, non-healing wounds, and sexual dysfunction. 10 patients underwent corrective surgery, with 2 requiring multiple procedures and 3 requiring split-thickness skin grafting. All 10 patients had an improved cosmetic appearance and those who had disabling shortening had significantly improved functional length. Clinical Implications Report of such adverse events should assist in appropriate perioperative counseling prior to genital enhancement surgery. Strength & Limitations Few reports of debilitating complications of penile enlargement exist in literature. However, without knowing the overall number of procedures performed, the true complication incidence is not known. Conclusion Penile and scrotal enhancement surgery can be associated with major disabling complications, leading to deformity and functional compromise in men with prior normal anatomy and function. Patients should be aware of these risks.

Removed: The Augmenta Implant: A Cadaver Model of a Novel Anatomic Subdermal Implant for Cosmetic Penile Enhancement

“…5 These procedures have not been widely accepted by the medical community because of potential complications and historically poor cosmetic outcomes. 6 In response to these shortcomings, we have developed a novel subcutaneous hydrophilic-coated cosmetic penile implant (CPI) known as Augmenta. Augmenta was designed to permit safe anatomic expansion that enhances the natural cosmetic penile appearance without encumbering normal penile movement and function.…”

Average-Size Erect Penis: Fiction, Fact, and the Need for Counseling

“…A recent review of 17 studies found that the large majority of "normal men complaining of small penis size" (i.e., men who did not have abnormalities of the penis), in fact, had normal size penises (Marra, Drury, Tran, Veale, & Muir, 2020). Reviews of penile enlargement surgery have deemed it to be "a highly risky procedure" with "documented and significant complications" (Dillon et al, 2008;Furr, Hebert, Wisenbaugh, & Gelman, 2018;Urology Care Foundation, 2019;Wylie & Eardley, 2007). As a result, the American Urological Association's position is that the stretched penis length must be less than 2.95 inches (7.49 cm) to be considered for elongation surgery (Urology Care Foundation, 2019).…”

Penile Girth Injection Complications: A Case Report

“…1,3 In general, infection must be excluded when patients present with erythema, pain, and edema after an injection procedure because of the potential longterm consequences of penile infection. 4,5 Specific to hyaluronic acid injections, complications include penile subcutaneous nodules, subcutaneous bleeding, penile edema and infection. The most common of these complications is development of a subcutaneous nodule, with a reported incidence of 2.2%.…”