When is it used and how does ligamentotomy help?

Ligotomy is a surgical procedure that removes the suspensory ligament of the penis to increase the length of the organ. It is performed only according to indications, mainly when the length of the penis during sexual arousal is less than 12 cm.The surgeon can make an incision in the scrotum or along the pubic bone, but the first option is considered less risky. While you're recovering, you'll need to wear an extender every day - in fact, it's a special device used to lengthen the penis. Final results can only be assessed 6-10 months after surgery.Ligamentotomy costs range from $330 to $2800, depending on the clinic's pricing policy, services provided, and whether extenders are available.

Ligamentotomy – What is it?

Ligamentotomy is a surgery to increase the length of the penis. Its essence is to remove the suspensory ligament. In almost all cases, men will notice an increase in penis length of at least 2 cm, but this surgical intervention is not suitable for everyone - there are obvious contraindications.The surgery itself does not immediately increase the length of the penis; the patient must continually use an extender during recovery - the organ is only stretched after 6-10 months.

Instructions for use

Ligatotomy is performed at the request of the man; the main indication for surgery is a penis length of 12 cm at peak sexual arousal. This problem is often related to anatomical features of the structure of the congenital organ - the micropenis. However, there are other direct indications for suspensory ligament resection:

• Progressive cavernous fibrosis (replacement of the corpus cavernosum of the penis by connective tissue);
• Injury resulting in shortened penis length;
• Diagnosis of hereditary Klinefelter syndrome and Kallmann syndrome;
• Improper position of the urethral opening (hypospadias);
• A complete or partial split in the upper wall of the urethra (epispadias);
• Peyronie's disease, a severe curvature of the penis.

Contraindications

There are clear medical contraindications to ligamentotomy:

• Urogenital infectious diseases;
• Penis size exceeds 12 cm in arousal state;
• Skin lesions, symptoms concentrated in the perineum and groin;
• Unstable psycho-emotional background (this condition must be confirmed by a psychotherapist).

Even if the penis length reaches 12 cm, the surgeon refuses to perform the operation, which cannot bring physical satisfaction, while the psychological satisfaction is at an appropriate level.Infectious diseases and skin lesions are considered conditional contraindications. The doctor will first conduct a course of treatment to achieve full recovery or put the chronic disease into stable remission before allowing the man to undergo surgery.

What results can I expect before and after ligament surgery?

The penis looks completely different before and after ligamentotomy - usually the size increases by 3-5 cm, but the results may not be as "outstanding". In order to achieve the desired results, men must strictly follow all the recommendations of the doctor:

• Be well prepared - get tested, be examined by a cardiologist and andrologist, visit a psychotherapist, etc. ;
• Managing wounds during recovery;
• Refusing sexual intercourse for a certain period of time;
• Regularly use an extender - a device used to stretch the penis.

Ligamentotomy: Price

The price of ligamentotomy is quite high, which 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 it even guarantees maximum results.

Advantages and Disadvantages of Ligament Surgery

Ligament severing surgery has its advantages:

• The safety of the surgery, as it is not a penile reconstruction but a plastic surgery;
• Use local anesthesia rather than general anesthesia during surgery;
• The likelihood of complications and side effects is minimal;
• No need for a support device to be implanted in the penis;
• The ability to instantly increase the width of the penis during the procedure;
• Durability of results.

But some experts are adamantly opposed to ligamentotomy because it has many disadvantages: the surgeon's job is too expensive, requires weeks (sometimes months) of abstinence, and the likelihood of bleeding during recovery is high to achieve the desired results. It used to take a long time to recover.

Preparation for penile enlargement by ligamentotomy

Before performing penile enlargement with ligamentotomy, the patient must be prepared and first examined to determine contraindications; the rules are as follows:

• General urinalysis, bacterial culture;
• Biochemical and general blood tests;
• Allergy testing to determine the body's response to antibiotics;
• Ultrasound examination of pelvic organs;
• ECG, blood pressure control;
• Chest X-ray.

In addition, men must see a psychologist so that experts can identify mental abnormalities - they are absolute contraindications to manipulation. Additionally, as part of the preparation period, men are required to:

• Stop consuming alcoholic beverages at least 24 hours before the scheduled intervention date;
• Stop eating and drinking 6 hours before surgery;
• Any medications in the anticoagulation group were excluded 3 days before ligamentotomy;
• Shaving the groin area;
• Shower in the morning before the intervention.

How is penis enlargement performed via ligamentotomy?

Penile lengthening during ligamentotomy is performed according to a clear algorithm:

1. The man was placed on the couch.
2. The anesthesiologist does his job - administers spinal anesthesia.
3. Monitor the patient's condition - for nausea or vomiting, measure blood pressure, and check sensitivity in the area below the waist.
4. The surgeon makes an incision, feels the connective ligament with his fingers, and immediately cuts it with a scalpel.
5. Use your fingers to stretch the penis to its maximum possible length (separate indicator).
6. The incision is sutured and the surgical wound is covered with a sterile bandage.

In most cases, the standard course of the surgery changes if there is a need to increase the width of the penis at the same time. In addition, doctors can use different types of ligament resections - through the pubic bone or the scrotum.

Scrotal area resection

Features of scrotal regional ligament resection:

• The surgeon cuts the upper part of the seminal vesicle and immediately pushes the soft tissue away;
• Making an incision gives the doctor access to the entire ligamentous apparatus;
• sling ligament cruciate;
• 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 (up to 20 minutes in some cases);
• Complete recovery with no scarring;
• Minimized soft tissue trauma;
• After surgery, patients feel almost no pain.

Removal of the scrotal area allows for a ligamentotomy in overweight men—standard surgery would not be performed if large amounts of fatty tissue are present.

Pussy anatomy

This method is considered classic; the doctor makes an incision on the pubic bone, which makes his work easier - opening an area where the suspensory ligament can be freely separated and removed. However, pubic ligament incision has many disadvantages:

• Even after full recovery, a large scar remains on the pubic bone that later turns into a rough scar;
• Severe soft tissue damage will increase the recovery period;
• Men with more fatty tissue cannot have surgery;
• After surgery, the penis cannot be in the correct upward position during sexual arousal due to the pressure of the scar on the tissue.

Surgery to increase penis length through dissection of the pubic area lasts at least 60 minutes.

Recovery after endoscopic ligament incision

Endoscopic ligamentotomy involves long-term recovery, during which:

• Wear an extender – a special device that can only be worn the day after surgery;
• Observe the time of wearing the extender - no more than 2 hours of continuous wear on the first day, gradually increase to 8 hours;
• You need to abstain from sex for at least two weeks;
• Personal hygiene regulations should be strictly observed to avoid infection;
• Patients should see their doctor regularly to monitor recovery;
• The surgical wound dressing is changed three times a day.

Men are strictly prohibited from using ointments, creams, or any medications not prescribed by their attending physician on the sutures. Patients should avoid physical activity for 4 weeks and then be extremely moderate.

possible complications

The most common complications after ligament surgery are:

• Changes in male sexual potency - for which the surgeon is solely responsible;
• severe pain during recovery;
• Perineal swelling and hematoma will disappear on their own within 4-6 days after surgery;
• Infections in the surgical area;
• Bleeding – The blame is placed on patients who don’t follow the rules of recovery.

If infectious agents enter the surgical wound, this may lead to suppuration, adhesion formation, and progression of inflammation in the testis and its adnexal tissue (orchiepididymitis).

Effect on patients

The final result of the ligamentotomy can only be evaluated by the patient 6-10 months after surgery, when the extender wearing process is complete and the increment has reached maximum. Usually the length of the penis will increase by 2-7 cm, which completely depends on the individual characteristics of the man's body and the anatomical characteristics of the penis structure. But almost every patient reports an improvement in the quality of their sexual life.Lagotomy is the most effective method of increasing penis length and requires surgery and a long recovery period. If the patient strictly follows the doctor's recommendations and uses the extenders correctly, the results are bound to be positive.