Ligamentotomy is a surgical procedure for excision of the suspensatory 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 important 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 pubis, but the first option is considered less dangerous. During rehabilitation, it is necessary to wear an extender every day, a special device to lengthen the penis. The final results can only be evaluated 6-10 months after the surgery.
The cost of ligamentotomy varies 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 suspensatory ligament. In almost all cases, men notice an increase in the penis of at least 2 cm in length, but such surgery 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.
Directions 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 maximum sexual arousal. This problem is 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 suspensatory ligament:
- progressive cavernous fibrosis (the cavernous corpuscles of the penis are replaced by connective tissue);
- you have suffered injuries that have led to a decrease in the length of your penis;
- Klinefelter and Kallman syndromes of hereditary origin diagnosed;
- 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 genitourinary system;
- the size of the penis is more than 12 cm in a state of arousal;
- 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 an 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 a course of therapy, achieve complete recovery or introduce the chronic form of the pathology into a stable remission stage, and only after that it will be possible to allow the man to undergo surgery.
What results can you expect before and after ligamentotomy?
Before and after ligamentotomy, the penis looks radically different: an increase in its size of 3-5 cm is usually observed, but the result may be less "exceptional". To achieve the desired effect, a man must strictly follow all the recommendations of doctors:
- undergo comprehensive preparation: take tests, examine a cardiologist and an andrologist, visit a psychotherapist and so on;
- treat the injury during the rehabilitation period;
- refuse sexual intercourse for a certain period;
- regularly use an extender, a device for lengthening the penis.
Ligamentotomy: price
The price of ligamentotomy surgery is quite high, and this is a significant disadvantage of the method of increasing penis length, but it is also considered the most effective; in some clinics it even guarantees maximum results.
Pros and cons of ligamentotomy surgery
The ligamentotomy operation has its advantages:
- the safety of the procedure, because it is not penile reconstruction, but plastic surgery;
- the use of local anesthesia rather than general anesthesia during surgery;
- minimal probability of complications and side effects;
- there is no need to implant support devices in the penis;
- the ability to immediately increase the width of the penis during manipulation;
- 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 intercourse for several weeks (sometimes months), a high probability of bleeding already during rehabilitation period, long recovery before obtaining the desired result.
Preparation for penis enlargement with ligamentotomy
Before prescribing penis enlargement by ligamentotomy, the patient must undergo preparation and first be examined to identify contraindications; 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.
Also, a man must visit a psychologist so that the specialist can identify mental anomalies: 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 surgery date;
- stop eating and drinking 6 hours before surgery;
- exclude any drugs from the anticoagulant group 3 days before ligamentotomy;
- shave the groin area;
- shower in the morning before surgery.
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 sofa.
- The anesthetist does his job: administers spinal anesthesia.
- The patient's condition is monitored: if there is nausea or vomiting, blood pressure is measured and sensitivity in the area under the lumbar region is checked.
- The surgeon makes an incision, palpates 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 necessary. Additionally, the doctor may use different types of ligament excision, 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 removes the soft tissues;
- After an incision the doctor has access to the entire ligament system;
- the sling ligament is crossed;
- the suspensatory ligament is removed.
This method of manipulation is considered the safest and also has obvious 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 practically no pain.
Excision in the scrotal area made it possible to perform ligamentotomy for overweight men - 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 facilitates his work: a field opens for free isolation and excision of the suspensatory 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 increases the rehabilitation period;
- it is impossible to perform the operation on men with a large amount of adipose tissue;
- after surgery, the penis cannot assume the exact upward position at the moment of arousal due to tissue compression by the scar.
The operation to increase the length of the penis with dissection in the pubic area lasts at least 60 minutes.
Recovery after endoscopic ligamentotomy
Endoscopic ligamentotomy involves a long rehabilitation period, during which:
- wear an extender: a special device that can be worn only on the second day after surgery;
- compliance with the duration of use of the extender: the first days no more than 2 consecutive hours, gradually increase this figure up to 8 hours;
- it is necessary to abstain from sexual intercourse for at least 2 weeks;
- you should strictly observe the rules of personal hygiene to avoid infections;
- the patient must visit the doctor regularly 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 spots. The patient should refrain from physical activity for 4 weeks, then it 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;
- 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 respect 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 (epididymoorchitis) is possible.
Effect for patients
The patient can evaluate the final result of the ligamentotomy only 6-10 months after the operation, when the cycle of use of the extensor 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 all patients report an improvement in the quality of their sexual life.
Ligamentotomy is the most effective method to increase the length of the penis, which involves surgery and a long period of rehabilitation. If the patient strictly follows the doctor's recommendations and uses the extender correctly, the results will definitely be positive.