Penile advancement and lengthening for the management of post-circumcision traumatic short penis in adolescents.

Objective: To report on the safety of combing suprapubic fat liposuction, penile suspensory ligament severing, and Z-plasty of penoscrotal webbing for penile lengthening in cases of post-circumcision traumatic short penis in adolescents.

Methods: This prospective study was conducted in 9 male patients with a mean age of 15.6 ± 1.4 years. All patients had a short penis because of traumatic amputation of the glans in 7 patients and both glanular and partial distal corporal loss in 2 patients during circumcision. All were initially treated in childhood by penile skin advancement for phallic coverage. Penile length and circumference were measured pre- and post-operatively, both in the flaccid state at maximal stretch and in the erect state. Operative technique included Z-plasty of penoscrotal web, release of suspensory ligament, and suprapubic fat liposuction.

Results: Average functional penile length measured 3 months post-operatively had significantly increased by 18-30 mm (mean: 23 ± 4 mm) in the provoked, erect state. All patients had normally developed penile corpora cavernosa and wide circumference (mean: 11.7 ± 0.2 cm). No post-operative complications occurred in any of the patients. No patients had sexual partners or were sexually active.

Conclusions: The described technique of penile advancement and lengthening can be safely applied to patients with post-circumcision traumatic short penis.