Penis Büyütme ve Uzatma Girişimleri

Öz

Penis küçüklüğü Peyronie hastalığı, priapizm, radikal prostatektomiye ikincil gibi çeşitli etiyolojik faktörlere bağlı olarak meydana gelmektedir. Penis büyütme ya da uzatma tarih boyunca üzerinde çalışılan bir konu olmuştur. Erkeklerin çoğunda penis boyutu normal sınırlar içerisinde olmasına rağmen kendi penislerinin küçük olduğunu düşünmüşlerdir. Penis uzatma ya da büyütme girişimleri için başvuran erkek olguların çoğunluğunu dismorfofobi olarak adlandırılan bu grup oluşturmaktadır. Günümüzde penis büyütme için çeşitli cerrahi girişimler, dolgu maddeleri uygulamaları yapılmaktadır. Ancak bu cerrahi girişimler ile ilgili standart bir uygulamanın olmadığı, başarı kriterlerinin tam olarak ortaya konulamadığı anlaşılmaktadır. Bu derlemenin amacı penis boyutlarını arttırmak için uygulanan cerrahi yaklaşımların değerlendirilmesidir.

Anahtar Kelimeler

• Penis büyüklüğü
• cerrahi tedavi
• dolgu maddesi

Penis Enlargement and Lengthening Interventions

Öz

Small penis size occurs due to congenital or acquired factors such as Peyronie’s disease, priapism or secondary to radical prostatectomy. Penis enlargement or lengthening has been a subject studied throughout history. Most men think that their penis is small, although penis size is within normal limits. This group, called dysmorphophobia, constitutes the majority of male cases who apply for penile lengthening or enlargement attempts. Nowadays, various surgical interventions and filling materials are applied for penis enlargement. However, it is understood that there is no standard practice regarding these surgical interventions and the success criteria are not fully revealed. The purpose of this review is to evaluate the surgical approaches applied to increase penile size.

Anahtar Kelimeler

• Penis size
• surgical treatment
• filling material

Kaynakça

1. 1. Veale D, Miles S, Read J, et al. Phenomenology of men with body dysmorphic disorder concerning penis size compared to men anxious about their penis size and to men without concerns: a cohort study. Body Image. 2015;13:53-61.
2. 2. Wylie KR, Eardley I. Penile size and the ‘small penis syndrome’. BJU Int. 2007;99(6):1449-1455.
3. 3. Littara A, Melone R, Morales-Medina JC, Iannitti T, Palmieri B. Cosmetic penile enhancement surgery: a 3-year single-centre retrospective clinical evaluation of 355 cases.Sci Rep. 2019;9(1):6323. doi: 10.1038/s41598-019-41652-w.
4. 4. Vardi Y, Gruenwald I. The status of penile enhancement procedures. Curr Opin Urol. 2009;19(6):601-5.
5. 5. Youn G. Psychosocial perspectives on penile size. In: Park N.C., Kim S.W., Moon D.G., editors. Penile Augmentation. 1st ed. Springer; Berlin/Heidelberg, Germany: 2016. pp. 41–46.
6. 6. Talalaj J, Talalaj S. The strangest human sex ceremonies and customs. 1st ed. Melbourne, AU: Hill of Content; 1994.
7. 7. Veale D, Miles S, Read J, Troglia A, Carmona L, Fiorito C, Wells H, Wylie K, Muir G. Penile Dysmorphic Disorder: Development of a Screening Scale. Arch Sex Behav. 2015;44(8):2311-21.
8. 8. Veale D, Miles S, Read J, Bramley S, Troglia A, Carmona L, Fiorito C, Wells H, Wylie K, Muir G. Relationship between self-discrepancy and worries about penis size in men with body dysmorphic disorder. Body Image. 2016;17:48-56.

9. 9. Hehemann MC, Towe M, Huynh LM, El-Khatib FM, Yafi FA. Penile Girth Enlargement Strategies: What's the Evidence? Sex Med Rev. 2019;7(3):535-547.
10. 10. Yoram VA, Yaron HB, Tamir GB, Ilan GAA. Critical analysis of penile enhancement procedures for patients with normal penile size. Surgical techniques, success, and complications. Eur Urol. 2008;54:1042–50.
11. 11. Van Driel MF, Schultz WC, Van de Wiel HB, Mensink HJ. Surgical lengthening of the penis. Br J Urol. 1998;82(1):81-85.
12. 12. Mehraban D, Salehi M, Zayeri F. Penile size and somatometric parameters among Iranian normal adult men. Int J Impot Res. May-Jun 2007;19(3):303-9.
13. 13. Wessells H, Lue TF, McAninch JW. Penile length in the flaccid and erect states: guidelines for penile augmentation. J Urol 1996;156:995–7.
14. 14. Klein R. Penile augmentation surgery. San Francisco, CA: Electronic Journal of Human Sexuality; 1999. http://www. ejhs.org/volume2/klein/penis10.htm.
15. 15. Söylemez H, Atar M, Sancaktutar AA, Penbegül N, Bozkurt Y, Onem K. Relationship between penile size and somatometric parameters in 2276 healthy young men. Int J Impot Res. 2012;24(3):126-9.
16. 16. Ghanem H, ElKhaiat YI, Motawi AT, AbdelRahman IF. Infrapubic Liposuction for Penile Length Augmentation in Patients with Infrapubic Adiposities. Aesthetic Plast Surg. 2017;41(2):441-447.
17. 17. Zhang P, Wang B, Zhang X, Song Z, Bai W, Li Q, Xu T. Suprapubic Liposuction With a Modified Devine's Technique for Buried Penis Release in Adults. Plast Surg (Oakv). 2020;28(3):172-178.
18. 18. Li CY, Kayes O, Kell PD, Christopher N, Minhas S, Ralph DJ. Penile suspensory ligament division for penile augmentation: indications and results. Eur Urol. 2006;49(4):729-33.
19. 19. Spyropoulos E, Christoforidis C, Borousas D, Mavrikos S, Bourounis M, Athanasiadis S. Augmentation phalloplasty surgery for penile dysmorphophobia in young adults: considerations regarding patient selection, outcome evaluation and techniques applied. Eur Urol. 2005;48(1):121-7.
20. 20. Zhang X, Huang Z, Xiao Y, Kuang L, Zhang M, Zhang G, Li Q, Bai W, Xu T. Suspensory ligament release combined with acellular dermal matrix filler in infrapubic space: A new method for penile length augmentation. Andrologia. 2019;51(9):e13351. doi: 10.1111/and.13351.
21. 21. Xu L, Zhao M, Chen W, Li Y, Yang Z, Ma N, Wang W, Feng J, Liu Q, Ma T. Augmentation Phalloplasty With Autologous Dermal Fat Graft in the Treatment of "Small Penis". Ann Plast Surg. 2016;77 Suppl 1:S60-5.
22. 22. Zhang GX, Weng M, Wang MD, Bai WJ. Autologous dermal graft combined with a modified degloving procedure for penile augmentation in young adults: a preliminary study. Andrology. 2016;4(5):927-31.
23. 23. Sawhney CP, Banerjee TN, Chakravarti RN. Behaviour of dermal fat transplants. Br J Plast Surg 1969;22:169–76.
24. 24. Alter GJ, Jordan GH. Penile elongation and girth enhancement. AUA Update Series 2007;26:229–37.
25. 25. Srinivas BV, Vasan SS, Mohammed S.Penile lengthening procedure with V-Y advancement flap and an interposing silicone sheath: A novel methodology.Indian J Urol. 2012;28(3):340-2.
26. 26. Alter GJ. Augmentation phalloplasty. Urol Clin North Am. 1995;22:887–902.
27. 27. Wollin M, Duff PG, Malone PS, Ransley PG. Buried penis. A novel approach. Br J Urol 1990;65:97–100.
28. 28. Shirong L, Xuan Z, Zhengxiang W, Dongli F, Julong W, Dongyun Y.Modified penis lengthening surgery: review of 52 cases.Plast Reconstr Surg. 2000;105(2):596-9.
29. 29. Roos H, Lissoos I. Penis lengthening. Int J Aesth Restor Surg 1994;2:89–96.
30. 30. Monreal J. Composite augmentation phalloplasty: personal experience after 275 patients. Plastic and Aesthetic Research. 2015;Vol. 2, Issue 1.
31. 31. Klein, R. Penile augmentation surgery. San Francisco. CA: Electronic Journal of Human Sexuality (1999).
32. 32. Murtagh J. The ‘‘small’’ penis syndrome. Austr Fam Phys 1989;18:218–20.
33. 33. Perovic SV, Djordjevic ML.Penile lengthening.BJU Int. 2000;86(9):1028-33.
34. 34. Yang B, Liu XR, Hong QQ, Qiu RS, Ji CY. A comparative study on two kinds of surgical procedures of penile corpora cavernosa augmentation.J Plast Reconstr Aesthet Surg. 2009;62(3):357-64.
35. 35. Leungwattanakij S, Pummangura N, Ratana-Olarn K. Penile enhancement using a porcine small intestinal submucosa graft in a rat model. Int J Impot Res. 2006;18(1):39-43.
36. 36. Austoni E, Guarneri A, Cazzaniga A. A new technique for augmentation phalloplasty: albugineal surgery with bilateral saphenous grafts--three years of experience. Eur Urol. 2002;42(3):245-53.
37. 37. Giovanni Alei 1, Piero Letizia, Francesco Ricottilli, Pierfranco Simone, Lavinia Alei, Francesco Massoni, Serafino Ricci. Original technique for penile girth augmentation through porcine dermal acellular grafts: results in a 69-patient series. J Sex Med. 2012;9(7):1945-53.
38. 38. Alaa A Tealab 1, Aref M Maarouf 2, Mohamed Habous 3, David J Ralph 4, Safwat Abohashem. The use of an acellular collagen matrix in penile augmentation: A pilot study in Saudi Arabia.Arab J Urol. 2013;11(2):169-73.
39. 39. Dimitrije E Panfilov.Augmentative phalloplasty. Aesthetic Plast Surg. 2006;30(2):183-97.
40. 40. Kang dh, Chung JH, Kim YJ, Lee HN, Cho SH, Chang TH, Lee SW. Efficacy and safety of penile girth enhancement by autologous fat injection for patients with thin penises. Aesthetic Plast Surg. 2012;36(4):813-8.
41. 41. Spyriounis PK, Karmiris NI. Partial penile reconstruction following fat augmentation with anterolateral thigh perforator flap. J Plast Reconstr Aesthet Surg. 2012;65(1):e15-7.
42. 42. Zilg B, Råsten-Almqvist P. Fatal Fat Embolism After Penis Enlargement by Autologous Fat Transfer: A Case Report and Review of the Literature. J Forensic Sci. 2017;62(5):1383-1385.
43. 43. Yacobi Y, Tsivian A, Grinberg R, Kessler O. Short-term results of incremental penile girth enhancement using liquid injectable silicone: words of praise for a change. Asian J Androl. 2007;9(3):408-13.
44. 44. Furr J, Hebert K, Wisenbaugh E, Gelman J. Complications of Genital Enlargement Surgery.J Sex Med. 2018;15(12):1811-1817.
45. 45. Shamsodini A, Al-Ansari AA, Talib RA, Alkhafaji HM, Shokeir AA, Toth C. Complications of penile augmentation by use of nonmedical industrial silicone.J Sex Med. 2012;9(12):3279-83.
46. 46. Kim JJ, Kwak TI, Jeon BG, Cheon J, Moon DG. Human glans penis augmentation using injectable hyaluronic acid gel. Int J Impot Res. 2003;15(6):439-43.
47. 47. Kwak TI, Oh M, Kim JJ, Moon du G. The effects of penile girth enhancement using injectable hyaluronic acid gel, a filler. J Sex Med. 2011 Dec;8(12):3407-13.
48. 48. Yang DY, Ko K, Lee SH, Moon DG, Kim JW, Lee WK. Efficacy and safety of a newly developed polylactic acid microsphere as an injectable bulking agent for penile augmentation: 18-months follow-up. Int J Impot Res. 2017;29(4):136-141.
49. 49. Yang DY, Jeong HC, Ko K, Lee SH, Lee YG, Lee WK. Comparison of Clinical Outcomes between Hyaluronic and Polylactic Acid Filler Injections for Penile Augmentation in Men Reporting a Small Penis: A Multicenter, Patient-Blinded/Evaluator-Blinded, Non-Inferiority, Randomized Comparative Trial with 18 Months of Follow-up. J Clin Med. 2020 Apr 5;9(4):1024. doi: 10.3390/jcm9041024.
50. 50. Moon DG, Kwak TI, Cho HY, Bae JH, Park HS, Kim JJ. Augmentation of glans penis using injectable hyaluronic acid gel. Int J Impot Res. 2003;15(6):456-60.
51. 51. Kim JJ, Kwak TI, Jeon BG, Cheon J, Moon DG. Effects of glans penis augmentation using hyaluronic acid gel for premature ejaculation. Int J Impot Res. 2004;16(6):547-51.
52. 52. Monheit GD, Coleman KM. Hyaluronic acid fillers. Dermatol Ther. 2006;19:141–50.
53. 53. Funt D, Pavicic T. Dermal fillers in aesthetics: an overview of adverse events and treatment approaches. Clin Cosmet Investig. 2013;6:295-316.
54. 54. Mario De Siati 1, Oscar Selvaggio, Giuseppe Di Fino, Giuseppe Liuzzi, Paolo Massenio, Francesca Sanguedolce, Giuseppe Carrieri, Luigi Cormio. An unusual delayed complication of paraffin self-injection for penile girth augmentation. BMC Urol . 2013 Dec 1;13:66. doi: 10.1186/1471-2490-13-66.
55. 55. Yang DY, Ko K, Lee SH, Moon DG, Kim JW, Lee WK. Efficacy and safety of newly developed cross-linked dextran gel injection for glans penis augmentation with a novel technique. Asian J Androl. 2018;20(1):80-84.
56. 56. 15 Stenberg A, Lackgren G. A new bioimplant for the endoscopic treatment of vesicoureteral reflux: experimental and short‑term clinical results. J Urol 1995;154: 800–3.
57. 57. Casavantes L, Lemperle G, Morales P. Penile Girth Enhancement With Polymethylmethacrylate-Based Soft Tissue Fillers. J Sex Med. 2016;13(9):1414-1422.
58. 58. Perovic SV, Byun KS, Scheplev P, Djordjevic ML, Kim JH, Bubanj T. New perspectives of penile enhancement surgery: tissue engineering with biodegradable scaffolds. Eur Urol. 2006;49(1):139-47.
59. 59. Oh KJ, Park K, Kang TW, Kwon DD, Ryu SB. Subcutaneous metallic mercury injection for penile augmentation. Urology. 2007;69(1):185.e3-4. doi: 10.1016/j.urology.2006.10.028.
60. 60. Al-Ansari AA, Shamsodini A, Talib RA, Gul T, Shokeir AA. Subcutaneous cod liver oil injection for penile augmentation: review of literature and report of eight cases. Urology. 2010;75(5):1181-4.
61. 61. Gurdal M, Karaman MI. An unusual case of penile augmentation:subcutaneous stone implantation. Urology. 2002;59:445.
62. 62. Redmond E, Forde JC, Flood HD. Filling the void: a case of sepsis following the injection of a penile bulking agent. BMJ Case Rep. 2014;2014:bcr2013203054.
63. 63. Karakan T, Ersoy E, Hasçiçek M, Ozgür BC, Ozcan S, Aydın A. Injection of Vaseline under Penis Skin for the Purpose of Penis Augmentation. Case Rep Urol. 2012;2012:510612. doi: 10.1155/2012/510612.
64. 64. Solomon MP. Comments on "Nonsurgical Medical Penile Girth Augmentation: Experience-Based Recommendations". Aesthet Surg J. 2018;38(2):39-41.