OBJECTIVETo investigate the curative effect of penile elongation with four differentoperative approaches.

METHODSThrough four different operative approaches (the coronary sulcus ringincision, Y or Z shaped incision or Z shaped incision combined with coronary sulcus ring incision), thepenile skin and fascia were degloved until the penile root. Then the superficial and deep dorsal penilesuspensory ligament were cut off. After electric coagulation of the residue ends, the two-side tissue at thefront of the pubic symphysis was sutured. Then the penile skin and fascia were repositioned and the incisionat the inner and outer plate was closed.

RESULTSThe increased penile static length was (2.9 ± 0.2) cmwith abdominal wall Y incision (12 cases); (3.1 ± 0.3) cm with transabdominal modified Z incision (260 cases); (3.9 ± 0.7) cm with coronary sulcus ring incision (363 cases); (3.4 ± 0.8) cm with combined incision (39 cases). The lengthening effect was significantly different between the coronary ring incision and abdominal wall Y/Z incision (P < 0.05). The postoperative follow-up period was 6 months to 5.5 years without serious complications. Only 3 cases of subcutaneous hematoma occurred with treatment of debridement and drainage. 4 cases with ischemic necrosis at distal penile skin, were treated with debridement, dressing and physiotherapy, leaving no scar.

CONCLUSIONSPenile lengthening surgery are safe and effective through different approaches. The coronal ring incision has the best therapeutic effect.