Abstract
Objective
To introduce a postoperative protocol to optimize the final size of the penis in patients undergoing metoidioplasty.
Patients and Methods
Fourteen patients with the mean age of 29.3 years (8–40 ± 11.7), ten female transsexuals (46 xx karyotype) and four with 5-alpha-reductase deficiency syndrome (5ARDS) who had undergone extensive metoidioplasty entered a penile improvement protocol (PIP) between 2007 and 2015 at a specialized clinic in a general hospital in Tehran, Iran. Subjects were thoroughly instructed, rehearsed on the protocol and closely followed for 24 weeks. Written informed consent was obtained from all participants. We adapted a popular device, the so-called penile traction device, to accommodate the size of the neo-penis.
Results
All patients achieved an increase in their penile length with a mean of 28.42 mm (21–47 ± 6.86). Two subjects developed penile bruises and edema during the protocol implementation. No significant procedural complications were detected in the remaining 12 participants.
Conclusions
PIP can be an effective step in increasing the size of the neo-penis in patients who have undergone metoidioplasty. We suggest this procedure to be seriously considered in postoperative management of well-informed and motivated patients to improve the final penile length and function in this population. Larger studies are needed to further validate this protocol.
Level of Evidence II
This journal requires that the authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
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Acknowledgments
Special thanks to Dr. Majid Mokhtari and Dr. Arghavan Soheili for the heartfelt goodwill they put into the task.
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Cohanzad, S. Penile Improvement Protocol in Postoperative Management of Patients Undergoing Metoidioplasty. Aesth Plast Surg 40, 947–953 (2016). https://doi.org/10.1007/s00266-016-0700-3
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DOI: https://doi.org/10.1007/s00266-016-0700-3