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J Sex Med. 2019 Dec 9. pii: S1743-6095(19)31784-9. doi: 10.1016/j.jsxm.2019.11.260. [Epub ahead of print]

Augmentation Phalloplasty for Acquired Penile Shortening: A Systematic Review of Techniques, Outcomes, Patient Satisfaction, and Limitations.

Author information

1
Division of Plastic Surgery, Department of Surgery, Baylor College of Medicine, Houston, TX, USA. Electronic address: Amjed.abu-ghname@bcm.edu.
2
Division of Plastic Surgery, Department of Surgery, Mayo Clinic, Rochester, MN, USA.
3
Division of Plastic Surgery, Department of Surgery, Baylor College of Medicine, Houston, TX, USA.
4
Division of Plastic Surgery, Department of Surgery, University of Washington Medical Center, Seattle, WA, USA.

Abstract

INTRODUCTION:

Although an infrequent cause of small penile size in adult men, acquired penile shortening represents a particular reconstructive challenge due to preexisting penile anatomic deformities.

AIM:

With numerous techniques being performed, the purpose of our study is to assess available literature on length enhancement procedures used for acquired penile shortening deformities.

METHODS:

A systematic review was performed using the guidelines outlined in the Preferred Reporting Items for Systematic reviews and Meta-analyses. Medline/PubMed, Scopus, and Cochrane Databases were used to identify papers on augmentation Phalloplasty in non-transgender males with acquired penile shortening from 1990 to 2018.

MAIN OUTCOME MEASURE:

Outcomes, complications, and patient-reported satisfaction were analyzed.

RESULTS:

12 articles, involving 931 patients and 8 primary procedures, met our inclusion criteria. The majority of articles had level of evidence of 4 (83%) and Newcastle Ottawa Scale score of 6 (92%, moderate risk of bias). All studies reported mean penile length gain; however, inconsistent methodology was used when measuring penile dimensions. Mean length gain ranged from 0.6 to 6.4 cm. Overall, the mean complication rate for all techniques ranged from 0% to 50%. Post-operative satisfaction was reported in 10 (83%) studies, 7 of which used a validated scale. Patients were generally satisfied, with reported satisfaction rates ranging from 77% to 100%.

CLINICAL IMPLICATIONS:

While numerous procedures have been described, the significant limitations in the available data preclude identifying a single superior procedure.

STRENGTHS & LIMITATIONS:

The significant heterogeneity in the reported literature is a limitation of this study and highlights the need for standardized reporting. However, this study is the first to analyze augmentation phalloplasty literature in the setting of acquired penile shortening.

CONCLUSION:

Augmentation phalloplasty techniques for acquired penile shortening are evolving and are continuously being modified; best-practice guidelines are crucial to achieve safe and satisfactory outcomes in this population. Abu-Ghname A, Banuelos J, Davis MJ, et al. Augmentation Phalloplasty for Acquired Penile Shortening: A Systematic Review of Techniques, Outcomes, Patient Satisfaction, and Limitations. J Sex Med 2019;XX:XXX-XXX.

KEYWORDS:

Acquired Penile Shortening; Augmentation Phalloplasty; Penile Enhancement; Penile Lengthening; Peyronie's Disease

PMID:
31831387
DOI:
10.1016/j.jsxm.2019.11.260

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