Abstract:
Eur Urol. 2002 Sep;42(3):245-53; discussion 252-3.
A new technique for augmentation phalloplasty: albugineal surgery with bilateral saphenous grafts—three years of experience.
Austoni E, Guarneri A, Cazzaniga A.
Division of Urology, University of Milan, Ospedale S Giuseppe, Via S Vittore 12, 21123, Milan, Italy. edoardo.austoni@oh-fbf.it
OBJECTIVES: Penile augmentation surgery is a highly controversial issue due to the low level of standardisation of surgical techniques. The aim of the study is to illustrate a new technique to solve the problem of enlarging the penis by means of additive surgery on the albuginea of the corpora cavernosa, guaranteeing a real increase in size of the erect penis. METHODS: Between 1995 and 1997, 39 patients who requested an increase in the diameter of their penises underwent augmentation phalloplasty with bilateral saphena grafts. The patients considered eligible for surgery were patients with either hypoplasia of the penis or functional penile dysmorphophobia. All the patients included in our study presented normal erection at screening. The average penis diameter in a flaccid state and during erection was found to be 2.1cm (1.6-2.7 cm) and 2.9 cm (2.2-3.7 cm), respectively. Before surgery the patients were informed of the experimental nature of the surgical procedure. The increase in volume of the corpora cavernosa was achieved by applying saphena grafts to longitudinal openings made bilaterally in the albuginea along the whole length of the penis. RESULTS: No major complications and specifically no losses of sensitivity of the penis or erection deficiencies occurred during the post-operative follow-up period. All the patients resumed their sexual activity in 4 months. A measurement of the penile dimensions was carried out 9 months after surgery. No clinical meaningful increases in the diameter of the flaccid penis were documented. The average penis diameter during erection was found to be 4.2 cm (3.4-4.9) with post-surgery increases in diameter varying from 1.1 to 2.1cm (p<0.01). CONCLUSIONS: The penile enlargement phalloplasty technique with albuginea surgery suggested by the authors definitely is indicated for increasing the volume of the corpora cavernosa during erection. Albuginea surgery with saphena grafts has been found to be free from aesthetic and functional complications with excellent patient satisfaction.
PMID: 12234509 [PubMed - indexed for MEDLINE]
A new technique for augmentation phalloplasty
Elasticity of blood vessels.
Elasticity of blood vessels Introduction There are many blood vessels in the body. There are two main ones, arteries and veins. These blood vessels are able to expand in order to let more blood flow through them. They also contract to help control the flow of blood. Blood is pumped out of the heart to the body via the arteries and the veins carry the blood back to the heart. When the blood is in the blood vessels, pressure is present. In the arteries the blood is at higher pressure than it is when in the veins, arteries also have thicker walls (due to the high pressure) than the walls of the veins. The elasticity of arteries is what sustains the pressure on the blood when the heart relaxes and keeps the blood flowing in a forward direction. In the following experiment, we observed the elasticity of veins and arteries so that…
…artery was placed onto the paper clip. The length of the artery was then measured whilst it had no extra weight added to it. After this, a 10g weight was placed onto the weight holder, which was attached to the artery. The length was then measured and recorded. Another weight was then added on top of the previous weight, making the weight equal to 20g. The length of the artery was then recorded. Thereafter the addition of weights continued until it reached 100g, at each time adding 10g, whilst recording the length at each new weight. Once this was completed, we then needed to remove 10g of weight at a time and then recorded the new length (if changed) of the artery. This then allowed us to work out the elasticity of the blood vessel. Again, the weights continued to be removed until all the weights were taken off. This entire method was carried out with three separate pieces of artery and then the exact same method with the veins. During this experiment there are possible sources of error, which might have made the results inaccurate and on the whole, the entire experiment unfair. The pieces of artery and vein were not of the same diameter or width; this altered the strength of the pieces. Reading the length of the blood vessel using a ruler proved to be difficult which meant that the length could easily have been misread and therefore inaccurate. Results To gain the results of the elasticity of the artery and vein, the length of the blood vessel after the weight was removed was subtracted from the length of the blood vessel after the weight was added. The Elasticity of: Weight (g) Artery One Artery Two Artery Three 0 -2 1 5 10 5 3 5 20 3 6 4 30 7 12 6 40 7 8 6 50 6 8 9 60 8 6 10 70 6 6 7 80 5 5 4 90 4 3 4 100 3 2 3 Average 5.2 6 6.3 The Elasticity of: Weight (g) Vein One Vein Two Vein Three 0 -2 -3 -2 10 -2 -1 0 20 1 0 1 30 0 0 1 40 2 2 2 50 2 1 2 60 4 2 3 70 3 4 3 80 2 3 2 90 1 1 2 100 1 1 1 Average 1.2 1 1.5 Discussion Looking at my results I can see that there is clearly more elasticity in the arteries than there is in the veins. The length of the arteries when weights were added was longer than that of the vein. The longest length of the artery when the weight was added is 43mm and the longest length for this, of the vein is 30mm. The length of the artery after the weight is removed is close to the length it was at, when the weights were added. In comparison to this, the length of the vein didn’t return to the length it was at, when the weights were added as much as the arteries. Veins have a smaller/thinner layer of elastic fibres and smooth muscle and a large lumen. From this description of the vein, it is clear that the elasticity and strength of the vein is not very high. Due to the vein not having a thick layer of elastic fibres, we can see that …
Elasticity of blood vessels