Surgery to lengthen the penis (ligamentotomy)
– Yan Evgenievich, what caused the creation of the Pain Treatment Clinic? What are its features?
– Multidisciplinary clinic “Health 365”
has been operating in Yekaterinburg since 2008. Today it consists of five divisions in different areas of the city, including our Pain Treatment Clinic. This is a complex that brings together expert doctors with special training in the field of pain treatment. We use special techniques, laboratory methods and equipment, our activities are regulated by general rules and approaches to the diagnosis and treatment of pain, and internal management.
There are many manifestations of pain, and its effective treatment requires a systematic multidisciplinary approach. Chronic pain is dangerous because the longer it exists, the more difficult it is to treat; over time, it leads to the development of very complex structural changes in the central nervous system.
Often, patients turn to specialized specialists to get rid of pain, and they begin to walk in circles: from a therapist to a neurologist, from him to a surgeon, then to a neurosurgeon, a psychologist, and again to a therapist. A multisystem approach disproportionately increases cure and remission rates for various diseases
Our clinic is focused on the diagnosis and treatment of syndromes such as headaches and back pain, pain in the limbs, joints, as well as in the coccyx, sacrum and pelvis - a total of five basic areas. Our Clinic staff includes neurologists, therapists, neurosurgeons, ultrasound doctors, chiropractors, and massage specialists. Including three candidates of medical sciences, which once again confirms the level of qualifications of the staff.
– How is pain treated in your clinic? What innovative techniques and equipment are used?
– It all starts with an appointment with a doctor, who provides assistance in relieving acute symptoms of pain and recommends to the patient diagnostic tests, laboratory and instrumental, necessary for an accurate diagnosis of the cause of pain. After which complex treatment is prescribed - from the use of drug therapy and physiotherapy to invasive treatment - various blockades under ultrasound control, neurosurgical operations. Chronic pain disorder is often accompanied by anxiety and depressive disorders, so psychotherapy and psychopharmacotherapy may be included in the structure of our care.
Treatment also includes various non-drug methods. For common causes of pain (consequences of sports injuries, diseases of the musculoskeletal system), an innovative method such as kinesio taping is used. In accordance with certain anatomical rules, dense adhesive tapes are placed on the patient’s skin, which support the skin, fiber, muscles, relieve certain areas of the body, improve blood supply and lymphatic drainage, thereby significantly reducing pain. Another innovative method is plasma lifting. Plasma, which is obtained in concentrated form from the patient’s own blood, is separated from the blood, enriched with platelets and biologically active substances and injected, for example, into the tissue around a diseased joint. This plasma has good restorative and anti-inflammatory properties. In our clinic, both traditional devices, such as magnetic therapy devices, magnetic laser, ultrasound, amplipulse, and innovative equipment are actively used for physical procedures. For example, the Sympatocor-1 device is used to relieve migraine attacks and preventive treatment of headaches. It successfully and permanently relieves a person from repeated attacks of pain, subsequently reducing their frequency and intensity.
– What kind of pain do patients come to you with most often?
– Headaches and back pain are more common, closely followed by joint pain. If necessary, we use MRI (magnetic resonance imaging) to accurately diagnose the causes of such pain. An accurate and timely diagnosis means a lot for prescribing the correct treatment and saves the patient from going through agony. Our diagnostic complex, in addition to MRI, includes various types of ultrasound. The clinic, the only one in the city, performs ultrasound of peripheral nerves. This is very important when diagnosing compression of nerves, the so-called “tunnel syndromes”, for example, carpal tunnel syndrome, cubital tunnel syndrome, it allows you to see the localization and cause of compression of the nerve trunk. We carry out expert ultrasound diagnostics of the condition of the vessels of the head and neck. Very often, such a study makes it possible to verify the causes of headaches, such as impaired venous outflow, vertebrogenic compression of the vertebral arteries, muscle tension, and dysregulation of vascular tone. This provides a point of support for the general practitioner and neurologist. They gain a lever with which to solve a situation of severe, recurring pain, from which the patient sometimes despairs of finding relief and resigns himself. As a result of accurate diagnosis, we find this cause, which often responds well to treatment.
– What age patients predominate in your clinic?
– Pain in the cities is getting younger: a person sits at the computer all week without straightening up, and on the weekend he abruptly switches to classes in the gym or on the ski slope. And then he goes to our clinic complaining of back pain. With age, the incidence of diseases of the musculoskeletal system increases, including spinal osteochondrosis, deforming osteoarthritis, and damage to muscles and ligaments. Simple general tips to prevent the development of such diseases: try to lead a healthy lifestyle and promptly seek advice from specialists. Regarding the type and intensity of necessary physical activity. Of course, movement is life, but it is very important that it does not cause pain, but joy. Patients often come to us with complaints of pain in the extremities, in particular in the wrists and wrist joints, where the nerves lie closely together with the tendons. Inflammation occurs due to stress from prolonged routine work, for example, when working with a wrench, driving for a long time in a chair and steering wheel that is not adjusted in height and depth, when playing the piano, or working at an inconveniently located computer keyboard. Such pain can often make a person disabled. In this case, it is necessary to carry out a therapeutic and diagnostic blockade, treat the nerve directly, administer drugs that block pain, relieve inflammation and swelling, prevent further destruction of the nerve, and in some cases, perform neurosurgical intervention on the nerve. When performing pain blockades, our clinic uses high-tech methods: under the control of an ultrasound sensor (this is called ultrasound navigation) or an X-ray image in real time, a needle is brought exactly to the affected area, through which the necessary medicine is administered. The possibilities of such visualization during blockades practically eliminate the possibility of accidental damage to nerves and surrounding tissues and blood vessels and ensure increased safety of the procedure. Thanks to the pinpoint precision of administration, we are able to reduce the dose of the administered drug, thereby reducing the risks of developing unwanted reactions that are possible when administering high doses of the drug.
– How financially accessible are the clinic’s services to patients?
– Our clinic operates in the compulsory health insurance (CHI) system, since a large number of diseases accompanied by pain are included in the compulsory medical insurance system. The clinic also has a voluntary health insurance (VHI) department. According to current legislation, a doctor must advise a patient about the possibility of receiving free medical services. From a medical point of view, complexity and timeliness are of particular importance: if a patient undergoes an ultrasound today and an MRI six months later, this reduces the effectiveness of treatment to zero. We have developed special programs with significant discounts on sets of diagnostic procedures and pain treatment methods. At the same time, high-tech services, by definition, cannot be very cheap.
– In what directions will the clinic develop this year?
– In the coming years, our clinic will continue to introduce new types of medical services for the diagnosis and treatment of pain. These include various types of electrical neurostimulation, physiotherapy, new methods of neuroimaging, ultrasound, x-ray assistance, navigation in the treatment of pain syndromes. There will be a widespread introduction of minimally invasive operations, neurosurgical, low-traumatic procedures, which will allow surgical treatment of the cause of pain in 2-3 days. Further training for our doctors is planned; they will master related specialties, new treatment techniques, including diagnostic and invasive ones. We will also develop connections with other clinics and scientific schools specializing in the treatment of pain, both in our country and abroad. Our goal is to relieve our patients from any pain, from walking through torment: comprehensively, effectively and safely.
Effective solution
Ligamentotomy is an operation to enlarge the male penis by cutting a special suspensory ligament.
Through this connecting element, part of the phallus, hidden in the subcutaneous fat layer, is attached to the pelvic bone. After cutting it, the inner part of the penis is stretched using a special extender. In a similar way, the outer part of the genital organ is increased to 3-5 cm. With ligamentotomy, there is no direct lengthening of the phallus; the dimensions remain the same. Only the suspensory ligament is transected; further lengthening occurs using a stretching apparatus - an extender.
There are two ways to cross a ligament:
- Through the pubis.
- Through the scrotum.
Initially, ligamentotomy was performed through the pubic region. Technically this is simpler, as it allows direct access to the bundle. Performing an operation through the womb requires longer time, a larger incision, the procedure is accompanied by:
- Trauma to tissues and subcutaneous fat.
- Sutures and postoperative scars.
- Difficulty wearing an extender.
The scrotal approach is more acceptable, as it allows all manipulations to be performed through a minimal incision. Transecting the ligament through the scrotum is technically more difficult for the doctor, but is much easier for the patient to tolerate. The incision heals quickly, the scar is almost invisible.
The mobilization zone of the phallus with this method is 6-8 cm, which gives the maximum possible lengthening result after wearing the device.
The ligamentotomy itself is of an auxiliary nature; without subsequent traction it is meaningless.
During ligamentotomy, the suspensory ligament is crossed, and subsequent lengthening occurs using a traction apparatus
What does the result depend on?
Ligamentotomy does not make the penis longer; it appears larger visually.
Ligamentotomy is the most popular and sought-after operation for penis enlargement . During the surgical procedure, the penis is not made longer, but visually it appears larger. As a result of the surgeons' actions, the centimeters are redistributed to the visible part.
It should be noted that even with a strong desire, it will not be possible to achieve a penis enlargement of 10 cm. Already before the operation begins, the doctor can accurately determine the possibilities of a particular case. The best final result after surgical intervention is an addition to the length of 5 cm. If the result of ligamentotomy does not meet expectations, a rehabilitation course with mandatory additional manipulations at home can improve the postoperative result by 3 or even 5 cm.
The success of the operation largely depends on the skill of the surgeon and the implementation of medical recommendations. The constant tension of the penis, which is provided by the device, is sufficient for the formation of a scar and healing with the length that was obtained at the time of the operation.
After ligamentotomy it is important:
- Avoid physical activity for three weeks.
- Avoid active sex for 3-4 weeks.
- Always wear an extender (stretcher).
A couple of months after the ligamentotomy, the scar will finally form, and traction of the penis continues. In total, the device is recommended to be worn for up to six months. According to patient reviews, the result of the operation can be adequately assessed after 6-7 months. The cosmetic result of plastic correction of penis size depends on the skill of the surgeon and the individual characteristics of the patient.
Ligamentotomy: reviews, features of using the extender, possible complications
Over time, in place of the cut ligaments, areas of connective tissue form, which form new ligaments. Their size depends on proper postoperative procedures to maintain the results of surgery.
A few days after the ligamentotomy, an extender is placed on the penis. It is fixed in such a position to ensure proper tension of the ligaments and muscles of the penis, but at the same time to prevent the occurrence of pain and severe discomfort.
From indications to contraindications
Ligamentotomy is prescribed if the size of a man’s penis in an erect state is less than 12 cm. The list of medical indications for surgery includes:
- Peyronie's disease (acquired curvature of the penis).
- Cavernous fibrosis.
- Micropenis (hidden phallus).
Some men decide to enlarge the penis in this way to increase self-esteem or get rid of penile dysmorphophobia.
The operation is considered relatively safe, but not all men can do it. Absolute contraindications to ligamentotomy:
- Presence of mental illness.
- Poorly controlled hypertension.
- Diabetes.
- Blood clotting disorders.
- The length of the erect penis is more than 18 cm.
Any surgical intervention is associated with certain risks. Possible complications after ligamentotomy: infection, bleeding, scars. The list of rare consequences includes: changes in the natural angle of erection, decreased sensitivity, impotence. Their share is less than 0.1%. All this can be avoided if you turn to professionals.