Augmentation Phalloplasty for Acquired Penile Shortening: A Systematic Review of Techniques, Outcomes, Patient Satisfaction, and Limitations.
J Sex Med
; 17(2): 331-341, 2020 02.
Article
in En
| MEDLINE
| ID: mdl-31831387
ABSTRACT
INTRODUCTION:
Although an infrequent cause of small penile size in adult men, acquired penile shortening represents a particular reconstructive challenge due to preexisting penile anatomic deformities.AIM:
With numerous techniques being performed, the purpose of our study is to assess available literature on length enhancement procedures used for acquired penile shortening deformities.METHODS:
A systematic review was performed using the guidelines outlined in the Preferred Reporting Items for Systematic reviews and Meta-analyses. Medline/PubMed, Scopus, and Cochrane Databases were used to identify papers on augmentation Phalloplasty in non-transgender males with acquired penile shortening from 1990 to 2018. MAIN OUTCOMEMEASURE:
Outcomes, complications, and patient-reported satisfaction were analyzed.RESULTS:
12 articles, involving 931 patients and 8 primary procedures, met our inclusion criteria. The majority of articles had level of evidence of 4 (83%) and Newcastle Ottawa Scale score of 6 (92%, moderate risk of bias). All studies reported mean penile length gain; however, inconsistent methodology was used when measuring penile dimensions. Mean length gain ranged from 0.6 to 6.4 cm. Overall, the mean complication rate for all techniques ranged from 0% to 50%. Post-operative satisfaction was reported in 10 (83%) studies, 7 of which used a validated scale. Patients were generally satisfied, with reported satisfaction rates ranging from 77% to 100%. CLINICAL IMPLICATIONS While numerous procedures have been described, the significant limitations in the available data preclude identifying a single superior procedure. STRENGTHS &LIMITATIONS:
The significant heterogeneity in the reported literature is a limitation of this study and highlights the need for standardized reporting. However, this study is the first to analyze augmentation phalloplasty literature in the setting of acquired penile shortening.CONCLUSION:
Augmentation phalloplasty techniques for acquired penile shortening are evolving and are continuously being modified; best-practice guidelines are crucial to achieve safe and satisfactory outcomes in this population. Abu-Ghname A, Banuelos J, Davis MJ, et al. Augmentation Phalloplasty for Acquired Penile Shortening A Systematic Review of Techniques, Outcomes, Patient Satisfaction, and Limitations. J Sex Med 2020;17331-341.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Penis
/
Patient Satisfaction
/
Plastic Surgery Procedures
Type of study:
Guideline
/
Prognostic_studies
/
Systematic_reviews
Limits:
Adult
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Humans
/
Male
Language:
En
Journal:
J Sex Med
Journal subject:
GINECOLOGIA
/
MEDICINA REPRODUTIVA
/
UROLOGIA
Year:
2020
Type:
Article