Ligamentotomy is a surgical procedure for excising the suspensory ligament of the penis, which leads to an increase in the length of the organ. It is carried out only as indicated and the main 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, it is necessary to use an extender every day - a special device to actually lengthen the penis. Final results can only be assessed 6 to 10 months after surgery.
The cost of ligamentotomy ranges from $330-2. 800 and depends on the clinic's pricing policy, the services provided and the provision of an extender to the man.
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 penis length by at least 2 cm, but this 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 wear an extender during the rehabilitation period - the organ is lengthened only after 6 to 10 months.
Indications for use
Ligamentotomy is performed at the request of the man, the main indication for manipulation is a penis length of up to 12 cm in a state of peak sexual excitement. This problem is most 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 suspensory ligament:
- progressive cavernous fibrosis (the cavernous corpuscles 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 (hypospadias);
- complete or partial division 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 an excited state;
- skin pathologies with localization of symptoms in the perineum, groin;
- instability of the psycho-emotional context (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 bring physiological satisfaction, while psychological satisfaction is at the appropriate level.
Infectious diseases and skin lesions are considered conditional contraindications. Doctors will first conduct a course of therapy, achieve complete recovery or introduce the chronic form of pathology into a stage of stable remission, and only after that the man can undergo surgery.
What results can you expect before and after ligamentotomy?
Before and after ligamentotomy, the penis looks radically different - there is usually a 3 to 5 cm increase in size, but the result may be less "noticeable". To achieve the desired effect, a man must strictly follow all doctors' recommendations:
- undergo thorough preparation - taking tests, examination by a cardiologist and andrologist, consultation with a psychotherapist and so on;
- treat the wound during the rehabilitation period;
- refuse sexual relations 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 the length of the penis, but it is also considered the most effective, in some clinics they even guarantee the maximum result.
Pros and cons of ligamentotomy surgery
The ligamentotomy operation has its advantages:
- the safety of the procedure, as it is not penis reconstruction, but plastic surgery;
- the use of local anesthesia instead of general anesthesia during the operation;
- 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 very high, the need to abstain from sexual intercourse for several weeks (sometimes months), a high probability of bleeding already in rehabilitation period, long recovery before getting the desired result.
Preparation for penis enlargement with ligamentotomy
Before prescribing penile enlargement through ligamentotomy, the patient must be prepared and first of all 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.
In addition, a man must consult 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 date of the intervention;
- stop eating and drinking 6 hours before surgery;
- exclude any medications from the anticoagulant group 3 days before ligamentotomy;
- shave the groin area;
- shower in the morning before the intervention.
How is penis lengthening with ligamentotomy performed?
Stretching the penis during ligamentotomy is carried out according to a clear algorithm:
- The man is placed on the couch.
- The anesthetist does his job - gives spinal anesthesia.
- The patient's condition is monitored - if there is nausea or vomiting, blood pressure is measured and tenderness in the area below the lower back is checked.
- The surgeon makes an incision and feels 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 dressing 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 required. Also, the doctor can use different types of ligament excision - through the pubis or scrotum.
Excision in the scrotal area
Characteristics of excision ligamentotomy in the scrotal region:
- the surgeon cuts the upper part of the seminal sac and immediately separates the soft tissues;
- After an incision, the doctor has access to the entire ligament apparatus;
- the sling ligament is crossed;
- the suspensory ligament is excised.
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);
- there is no scar after complete rehabilitation;
- soft tissue trauma is minimized;
- After the operation, the patient practically does not feel pain.
Excision in the scrotal region made it possible to perform ligamentotomy in overweight men - a standard operation is not performed if there is a large amount of adipose tissue.
Dissection in the pubic region
This method is considered classic: the doctor makes an incision in the pubis, which makes his work easier - a field is opened for free isolation and excision of the suspensory 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 the procedure, the penis cannot assume the exact upward position at the time 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 period of rehabilitation, during which:
- use an extender - a special device that can only be used on the second day after surgery;
- compliance with the extender usage time - in the first few days no more than 2 hours in a row, gradually increase this number to 8 hours;
- you need to abstain from sexual intercourse for at least 2 weeks;
- you must strictly observe the rules of personal hygiene to avoid infections;
- the patient must regularly visit the doctor to monitor recovery;
- Change the dressing on the surgical wound three times a day.
It is strictly forbidden for men to apply ointments, creams and any medications not prescribed by the attending physician to the points. The patient must abstain from physical activity for 4 weeks, then it must be extremely moderate.
Possible complications
The most common complications after ligamentotomy are:
- changes in a man's sexual abilities – the surgeon is only to blame for this;
- the presence of severe pain during the recovery period;
- swelling and bruising in the perineal region, which disappear on their own 4-6 days after surgery;
- infection of the operational area;
- bleeding - the blame lies with the patient who does not comply with the rehabilitation rules.
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 their appendages (orchiepididymitis) are possible.
Effect for patients
The patient can evaluate the final result of the ligamentotomy only 6 to 10 months after the operation, when the use of the extensor ends and the increase reaches its maximum. Typically, the length of the penis increases by 2 to 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.