Penile Suspensory Ligament Spacer Removal

Lumbiganon, S, Bell, A, Azad, B, Chawareb, E, Yafi, F

Penile spacer, suspensory ligament, penile aesthetics procedure

Numerous penile enhancement procedures have been documented in the literature1, addressing anatomical and psychological aspects in patients with penile dysmorphic diseases. One commonly performed procedure is the division of the suspensory ligament1. Although not a true lengthening procedure, it effectively reduces the proximal angle of the penis, creating the appearance of increased external length. This minor surgical intervention is associated with few complications, with one notable concern being suspensory ligament reattachment, a risk mitigated by interposing with a spacer2. The spacer, in most cases, rarely causes problems or infections3.

Here, we present a unique case involving the removal of a suspensory ligament spacer due to bothersome symptoms and the presence of a hard lump in the pubic area. Despite being well-encapsulated in a thick capsule, the removal proved to be straightforward without any adhesions. To prevent ligament reattachment, the capsule was intentionally left in-situ. The surgical procedure was successful, and no short-term complications were observed. The patient expressed satisfaction with the initial 1-month post-operative result, reporting no subjective shortening.

References:

1. Shah BB, Kent M, Valenzuela R. Advanced Penile Length Restoration Techniques to Optimize Penile Prosthesis Placement Outcomes. Sexual Medicine Reviews. 2021 Oct 1;9(4):641–9.

2. Li CY, Kayes O, Kell PD, Christopher N, Minhas S, Ralph DJ. Penile Suspensory Ligament Division for Penile Augmentation: Indications and Results. European Urology. 2006 Apr 1;49(4):729–33.

3. Rossi A, Alei G, Frisenda M, Tufano A, Viscuso P, Mantica G, et al. Penile lenghthening original technique using a pubo-cavernous spacer. Long term results from a series of over 200 patients. Archivio Italiano di Urologia e Andrologia. 2022 Sep 26;94(3):339–44.