title: Venous ligation: a novel strategy for glans enhancement in penile prosthesis implantation.
abstract: Although penile implantation remains a final solution for patients with refractory impotence, undesirable postoperative effects, including penile size reduction and cold sensation of the glans penis, remain problematic. We report results of a surgical method designed to avoid these problems. From 2003 to 2013, 35 consecutive patients received a malleable penile implant. Of these, 15 men (the enhancing group) were also treated with venous ligation of the retrocoronal venous plexus, deep dorsal vein, and cavernosal veins. The remaining 20 men formed the control group, treated with only a penile implant. Follow-up ranged from 1.1 to 10.0 years, with an average of 6.7 ± 1.5 years. Although preoperative glanular dimension did not differ significantly between the two groups, significant respective difference at one day and one year postoperatively was found in the glanular circumference (128.8 ± 6.8 mm versus 115.3 ± 7.2 mm and 130.6 ± 7.2 mm versus 100.5 ± 7.3 mm; both P<0.05), radius (38.8 ± 2.7 mm versus 37.1 ± 2.8 mm and 41.5 ± 2.6 mm versus 33.8 ± 2.9 mm; latter P<0.01), and satisfaction rate (91.7% versus 53.3%, P<0.01) as well. Based on our results, selective venous ligation appears to enhance the glans penis dimension in implant patients.
authors.affiliation: Microsurgical Potency Reconstruction and Research Center, Hsu's Andrology and National Taiwan University, 3F 88, Wen-Hu Street, Neihu District, Taipei City 11445, Taiwan ; Department of Urology, National Taiwan University Hospital, College of Medicine, Taipei City 10048, Taiwan.
authors.forename: Geng-Long
authors.identifier: 0000-0002-5383-2252
authors.initials: GL
authors.lastname: Hsu
authors.affiliation: Department of Radiology, University of Southern California, Los Angeles, CA 90033, USA.
authors.forename: James W
authors.initials: JW
authors.lastname: Hill
authors.affiliation: Division of Urology, Buddhist Tzu-Chi General Hospital, Taipei Branch, School of Medicine, Buddhist Tzu-Chi University, Hualien City 970, Taiwan.
authors.forename: Cheng-Hsing
authors.identifier: 0000-0003-3017-2850
authors.initials: CH
authors.lastname: Hsieh
authors.affiliation: Department of Urology, National Taiwan University Hospital, College of Medicine, Taipei City 10048, Taiwan.
authors.forename: Shih-Ping
authors.initials: SP
authors.lastname: Liu
authors.affiliation: Microsurgical Potency Reconstruction and Research Center, Hsu's Andrology and National Taiwan University, 3F 88, Wen-Hu Street, Neihu District, Taipei City 11445, Taiwan.
authors.forename: Chih-Yuan
authors.identifier: 0000-0002-9337-9341
authors.initials: CY
authors.lastname: Hsu
mesh_terms: D000328:Adult; D005500:Follow-Up Studies; D006801:Humans; D008026:Ligation / Q000379:methods; D008297:Male; D008875:Middle Aged; D019935:Penile Implantation / Q000379:methods*; D015917:Penile Prosthesis; D010413:Penis / Q000098:blood supply* / Q000473:pathology / Q000601:surgery*; D014680:Veins / Q000473:pathology / Q000601:surgery; D055815:Young Adult