A new method of plastic surgery of the glans penis in patients with hypospadias

Penile deformity is a curvature of the penis in an erect state.

Curvature of the penis can cause aesthetic discomfort to a man, and also cause difficulties during sexual intercourse.

At the REFORMEN men's health center, we have accumulated extensive experience in treating penile deformation, which allows us to effectively cope with this disease.

If you are concerned about the issues described above, schedule a consultation online or by phone.

What and how we treat

Many urological pathologies that develop after injuries, previous surgical interventions, or are congenital, significantly affect a person’s quality of life. Effective treatment of some of these diseases is only possible through surgery.

The operations we perform have proven effectiveness, and in some cases they are the gold standard of treatment. However, every operation cannot be performed according to a template, since almost every case in reconstructive surgery is unique. Proven diagnostic methods, extensive surgical experience and sensitive attention to the details of our medical problems allow us to choose the right tactics and predict the result.

Postoperative period

After discharge, it is necessary to limit physical activity for 1 week, and also apply dressings for some time.

During the entire recovery period after surgery (about one month), it is necessary to refrain from sexual activity in any form, including masturbation. At the end of the recovery period, the man can return to intimate life in full. Around this time, the seam, made using a special cosmetic technique, becomes almost invisible.

Possible complications and contraindications will be discussed with you individually by your attending physician.

Surgeries on the penis

A number of operations help correct the appearance of the penis, and also prevent possible more serious complications. The following operations on the penis are performed in our clinic:

• Plastic surgery of the foreskin frenulum for a short frenulum
• Meatotomy and meatoplasty for dilation of the urethra
• Operation circumcision - surgical treatment of phimosis (narrowing of the foreskin) and paraphimosis
• Separation of adhesions (synechiae) of the foreskin of various categories of complexity
• Excision of genital warts from the external opening of the urethra, scaphoid fossa of the urethra
• AL-Ghorab type operations for priapism
• Operations to restore the skin of the penis
• Operations for oleogranulomas of the penis

Peyronie's disease

Separately, it is worth highlighting Peyronie's disease, which is also known as fibroplastic induration of the penis. To understand why the penis is deformed during erection, we must remember that the corpora cavernosa, enclosed in a dense membrane called the albuginea, is responsible for the mechanism of erection. With Peyronie's disease, a process similar to scarring occurs in certain places of this membrane. As a result, hard plaques form in the penis, which change its shape during erection and also cause pain and discomfort.

Surgeries to correct hypospadias and epispadias

Hypospadias is the abnormal development of the urethra. Specialists at the Andros Clinic perform more than 30 types of surgical operations for hypospadias. The exact method of surgical intervention is determined by the doctor after familiarizing himself with the patient’s medical history, as well as a thorough diagnosis. Below are a number of operations that are performed in the clinic for hypospadias:

• Meatotomy with glanuloplasty for capitate hypospadias
• Snodgrass operations for capitate, crown, distal trunk, proximal trunk, penoscrotal hypospadias
• Urethroplasty by Ducket, Koyanagi
• Two-stage hypospadias repair according to Bracka I, Bracka IIb, etc.

Who is corporoplasty indicated for?

According to medical recommendations, penile plastic surgery for Peyronie's disease is required for men if the angle of curvature of their penis in an erect state is more than 20 degrees. If the curvature is not so significant, you can do without surgery, since such severity of the defect does not interfere with sexual life. Although the last word always remains with the patient, and the operation can be performed on a man with any degree of deformity.

In case of serious impairment of erectile function due to Peyronie's disease, or with a high risk of impotence after surgery, the patient may be offered endophalloprosthetics with a plastic or inflatable three-component prosthesis with simultaneous modeling of the penis (plaque stretching) or corporoplasty with the application of a graft. It should also be said that corporoplasty is necessarily carried out together with circumcision.

To treat penis curvature and solve any other urological problems, you need to contact only professionals in order to maintain full urinary and sexual functions.
You will always receive qualified assistance at the Urology Clinic named after R. M. Fronshtein of the First Moscow State Medical University named after I.M. Sechenov (State Urology Center). If you experience symptoms of the disease, do not waste time and make an appointment with your doctor. September 14, 2020
Akopyan Gagik Nersesovich - urologist, oncologist, MD, doctor of the highest category, professor of the Department of Urology of the Federal State Autonomous Educational Institution of Higher Education First Moscow State Medical University named after. THEM. Sechenov

Clinic of Urology named after R. M. Fronshtein of the First Moscow State Medical University named after I.M. Sechenov invites you to an appointment with experienced urologists. To get an appointment with a qualified specialist, just fill out a short online application. Be sure to fill out all the fields, including a brief description of the symptoms (the “Information” column), specify whether you are interested in a secondary or primary appointment.

Pay attention to the “Attach file” button - it allows you to immediately send medical documents to the doctor in electronic form. This may include images, tests and other information that will be important to determine the diagnosis.

Still have questions? Call us by phone or! On a weekday, you can come for a consultation with a doctor within a few hours after filling out the online application. Do not delay visiting a specialist if you are concerned about your genitourinary health!

Operations for urethral strictures

The Andros Clinic occupies an expert niche in the problem of urethral stricture or pathological narrowing of the urethra. In particular, the leading specialist on this issue - urologist, andrologist, reconstructive surgeon Alexey Zhivov performs up to 100 reconstructive operations per year. The decision in favor of one or another surgical treatment depends on the extent and location of the urethral stricture. Below is a partial list of surgical interventions for urethral stricture of varying length and location.

• Transurethral resection of the area of ​​urethral stricture, contracture of the urethro-vesical anastomosis of various categories of complexity
• Perineal urethrocutaneostomy of varying complexity
• Plastic surgery of urethral strictures of various lengths using the “anastomosis without intersection” method
• Stricture plastic surgery according to Turner-Warwick/Webster of various categories of complexity
• Augmentation plasty of strictures of various locations and extents
• Two-stage urethroplasty using oral mucosa or another graft according to Barbagli or Kelkarni of various locations and extents

How to prepare for frenuloplasty

In the process of preparing for surgery, you should consult with a urologist, who will draw up a complete list of recommendations based on the individual characteristics of the patient and the results of the tests performed. A week before the planned procedure, it is necessary to avoid taking any aspirin and non-steroidal anti-inflammatory drugs.

On the day of surgery, you need to perform a number of simple steps:

• carry out a thorough toilet of the genitals and hygienic cleaning using special products for the care of the intimate area;
• shave the scrotal area;
• give up caffeine in the morning, and breakfast should be as light as possible, without fatty foods;
• Bring a set of sterile wipes and spare linen with you to the clinic.

If the patient is allergic to various drugs, you must inform your doctor about this, and take an antihistamine the day before frenuloplasty. In cases of a negative reaction of the body to general anesthesia, it is required to notify the anesthesiologist.

Compliance with all general recommendations for preparing for the correction procedure contributes to the most effective implementation of all surgical procedures with minimal risks of subsequent deviations.

Operations on the scrotal organs

Scrotal surgery is generally not suitable for all patients. For example, one option for a testicular cyst or spermatocele is regular monitoring by a urologist. However, there are diseases that require urgent surgical intervention, for example, malignant testicular tumors. In any case, the decision to operate on the scrotal organs is made by the doctor after a thorough diagnosis, in particular, ultrasound of the scrotal organs.

• Excision of spermatocele and funicolocele
• Operation of Winckelmann, Bergmann and Lord for hydrocele (hydrocele)
• Subinguinal microsurgical varicocelectomy according to Marmar or Goldstein on one or both sides for varicocele
• Testicular prosthesis

Indications for surgery

Medical indications for phalloplasty relate to:

• small penis and micropenis;
• developmental defects (epi- and hypospadias);
• genital injuries;
• traumatic amputation;
• gender change.

Other programs that allow you to enlarge the penis are performed at the request of the patient.

Contraindications are the same for any planned surgical interventions:

• temperature increase;
• acute infectious process;
• diabetes;
• severe pathologies of internal organs.

Preparation, diagnostics

Preoperative examination includes:

• consultation with a urologist-andrologist;
• blood and urine tests;
• Ultrasound, CT, MRI of the penis, scrotum;
• ECG;
• chest x-ray;
• if necessary, uroflowrometry and urethrography;
• if necessary, cavernosography, cavernosometry, intracavernous test;
• consultations with an anesthesiologist and doctors of other specialties (as indicated).

You are allowed to have a light dinner 10–12 hours before the operation, and on the day of the intervention you are prohibited from eating, drinking and smoking. Be sure to tell your doctor if you have any drug allergies and regularly take dietary supplements and medications.

How much does the operation cost?

An analysis of the prices of penis enlargement operations shows a wide variation in the cost of treatment.

• In Moscow, prices for ligamentotomy range from 20,000 to 200,000 rubles;
• lipofilling - price starts from 10,000 rubles;
• muscle transplantation - $1500-2500;
• penile prosthetics - from 20,000;
• introduction of gel and silicone implants - the average price in Moscow is from 1,000,000, depending on the implant;
• prices for hyaluron injections in the table

• introduction of the matrix from $1000.

Editorial opinion

Igor Radevich

Expert of the site Uvelicheniechlena.live

The price ranges from 10-20,000 - this is only surgical intervention, without taking into account the costs of the patient’s hospital stay and drug treatment.

Causes

The pathogenesis of the disease is not fully understood. There are several theories that provoke penile curvature. It can be a consequence of two factors: congenital and acquired.

Congenital forms:

• heredity, the presence of gene abnormalities that are responsible for the synthesis of connective tissue protein collagen. Morphologically, the formation of connective tissue cords is noted in the cavernous bodies;
• abnormalities of organ development, short urethra, changes in the structure of the vascular network of the organ, hypoplasia of the tunica albuginea. The irregular shape of the penis is noticeable when it is filled with blood (erect state).

Purchased forms:

• injuries, bruises, organ fractures, which lead to the formation of hematomas and the development of inflammation. Without adequate therapeutic measures, the regeneration process leads to the formation of fibrous tissue of the cavernous bodies. Scar changes can thicken and cause deformation of the penis;
• autoimmune diseases. Cells of the immune system are able to attack their own tissues and cause damage, plaques and scars;
• drug therapy for diseases of the cardiovascular system, the use of beta blockers;
• drug treatment of impotence. Repeated administration of drugs injures the protein membrane of the organ and causes scarring;
• the use of various methods of stretching the penis, which provokes disruption of blood flow;
• vascular atherosclerosis, diabetes mellitus;
• connective tissue diseases: Dupuytren's contracture, Paget's disease, tympanosclerosis;
• hypo-, tocopherol vitamin deficiency, deficiency of microelements: calcium, magnesium;
• hypersecretion of the hormone serotonin;
• age-related changes in tissue elasticity.

Recovery

The longest recovery period is observed after phalloplasty. Hospital stay reaches 2 weeks. For 2 months physical activity and sex life are limited. This also applies to lipofilling. The remaining interventions allow sexual activity after 2 weeks.

• Injections of hyaluronic acid - visiting the sauna and taking hot baths is limited.
• Ligamentotomy requires wearing an extender.
• Moderate pain is relieved by taking non-steroidal anti-inflammatory drugs.

Cost of services

The prices indicated in the price list may differ from the actual prices. Please check the current cost by calling +7 495 104 8605 (24 hours a day) or at the GMS Hospital clinic at the address: Moscow, st. Kalanchevskaya, 45.

Dear Clients! Each case is individual and the final cost of your treatment can only be found out after an in-person visit to a GMS Hospital doctor. Prices for the most popular services are indicated with a 30% discount, which is valid when paying in cash or by credit card. You can be served under a VHI policy, pay separately for each visit, sign an agreement for an annual medical program, or make a deposit and receive services at a discount. On weekends and holidays, the clinic reserves the right to charge additional payments according to the current price list. Services are provided on the basis of a concluded contract.

Plastic cards MasterCard, VISA, Maestro, MIR are accepted for payment. Contactless payment with Apple Pay, Google Pay and Android Pay cards is also available.

Western standards of treatment (evidence-based medicine)

Continuous staff development

Regular interaction with leading Russian and foreign medical institutions

Modern medical equipment and advanced diagnostic and treatment methods

Unified standard of service

We work around the clock 24/7/365

Make an appointment We will be happy to answer any questions Coordinator Oksana

Introduction of hyaluronic acid

The modern procedure allows you to quickly and permanently thicken and increase the size of the penis or its head. The technique involves injecting hyaluronic acid (a natural polysaccharide) under the fibrous membrane of the penis.

Progress of the procedure:

1. Hair removal in the groin area.
2. Applying an anesthetic to prevent discomfort.
3. Injecting only those areas that need augmentation.

The result lasts up to 12 months or more. Hyaluronic acid is biocompatible with body cells, therefore it does not cause rejection or allergic reactions.

What indications to use

The penis with testicles and urethra are a complex system that provides reproductive, urinary and copulatory (sexual) functions. Traumatic injuries, birth defects, genitourinary diseases - all these factors can lead to functional problems and aesthetic problems with the genitals, and sometimes to the loss of their basic functions.

Indications for surgical intervention on the penis, urethra, testicles and scrotum are:

• phimosis, paraphimosis;
• erectile disfunction;
• developmental defects of the penis;
• cavernous fibrosis;

• Peyronie's disease (accompanied by erectile dysfunction);
• injuries to the penis, scrotum, urethra;
• unsuccessful operations on the genitourinary organs;
• consequences of surgical treatment of tumors of the rectum, prostate, bladder;
• vascular (vasculogenic) impotence;
• ineffectiveness of conservative methods.

The genital surgery techniques used at GMS Hospital can effectively solve congenital or acquired problems of the male reproductive system with the best functional and cosmetic results.

Ligamentotomy

This method has distinct advantages, including minimal risks of complications and immediate results. The length of the penis after surgery increases by 3-5 cm.

Indications:

• erection size no more than 12-16 cm;
• patient's wish

The essence of ligamentotomy is to make an incision into the tissue - the supporting ligament. As a result, separation from the pubic surface occurs, which leads to an increase in size.

The operation is performed under general anesthesia and lasts 30-60 minutes. The specialist makes an incision in the scrotum or pubic area, trims the ligament and fixes it in the desired position. To achieve a better result, the vacated space is filled with fatty tissue. This eliminates the possibility of adhesions and facilitates the rehabilitation process.