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“Make it as long as you can, Doc.” Concomitant surgical treatments with penile implant to enhance penile size


The constant refrain for patients seeking penile implant is, “can you make it bigger?” It is a different request when the patient is young and fully potent compared with the mature individual suffering from erectile dysfunction (ED) for whom conservative therapies don’t work. The purpose of this workshop is to review strategies to make the ED patient undergoing inflatable penile prosthesis (IPP) have an enhanced penile appearance by having more of his phallus visible outside his body. Our common procedures are to use a combination of vacuum device preparation, oversizing the cylinders 1–2 cm, and daily aggressive cycling of the device for at least 6 months following implantation. More complex surgical solutions are also covered.

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Fig. 1
Fig. 2
Fig. 3
Fig. 4: IPP as tissue expander allowing longer replacement cylinders.
Fig. 5: Ventral phalloplasty or scrotoplasty.
Fig. 6: Carrion’s ventral phalloplasty improves appearance of penis.
Fig. 7: Shaeer’s ventral phalloplasty.
Fig. 8: Wang’s sliding procedure through long ventral penile incision.
Fig. 9: Egydio’s multiple slit technique (MUST).
Fig. 10: Penuma penile implant for prepubic recession.
Fig. 11: Two patients IPP + Penuma Implant.
Fig. 12: “S”-shaped deformity of lengthening cylinder.

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Correspondence to Steven K. Wilson.

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SKW: Consultant AMT, Coloplast, International Medical Devices. Stockholder Neotract. Lecturer Boston Scientific. LL: Consultant Coloplast, International Medical Devices. RW: Consultant Coloplast, International Medical Devices.

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Wilson, S.K., Levine, L. & Wang, R. “Make it as long as you can, Doc.” Concomitant surgical treatments with penile implant to enhance penile size. Int J Impot Res 33, 587–595 (2021).

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