Brazilian doctors create penile reconstruction method that even allows erections

Brazilian doctors create penile reconstruction method that even allows erections

Brazilian scientists have managed to develop a new surgical technique to reconstruct or enlarge the penis and even artificially make one for trans men – and the best part, the organ is able to sustain an erection normally. The technique was described in a publication in the scientific journal International Brazilian Journal of Urology.

Leading the team is the urologist Ubirajara Barroso Junior, a specialist in genital reconstruction. So far, doctors have already managed to perform the operation on amputees, with micropenis and on a trans man. Previously, reconstructive operations used skin from other parts of the body to remake the organ, but without the ability to swell up like a normal penis.

Amputees, micropenis patients and trans men: there are several who benefit from the new method of penile reconstruction that even allows erections (Image: Prostock-studio/envato)

How the new penile reconstruction method works

Internally, the penis has basically 3 cylinders: in the center, there is the corpus spongiosum, surrounding and protecting the urethra, through which the urine passes. Surrounding it are two cylinders called corpora cavernosa, which fill with blood when there is sexual stimulation, causing the organ to become erect.

The absence of corpora cavernosa is what invalidates old methods of penile reconstruction, and even the corpus spongiosum is different: in artificial organs, the urethra ends in a hole at the bottom of the penis, causing the individual to urinate sitting up. Internal rigid prostheses are not ideal, as the penetration movements cause the tissue to tear and the prosthesis to come out.

With only the skin present and the absence of a cartilaginous structure to give resistance to the artificial penis, even inflatable prostheses are ineffective: in 50% of the cases, it also pierces the organ and escapes. Compounding the situation, it is very expensive, costing up to R$90,000. Doctors from universities in Bahia, then, studied a way out: using the corpora cavernosa outside the penis.

The new method uses the corpora cavernosa present in the perineum to ensure the functioning of the penis, including erection (Image: Ubirajara et al./Int. Brazilian Journal of Urology)
The new method uses the corpora cavernosa present in the perineum to ensure the functioning of the penis, including erection (Image: Ubirajara et al./Int. Brazilian Journal of Urology)

Half of the body’s corpora cavernosa is in the penis — the rest is in the perineum, the area between the scrotum and anus. Previous attempts to reuse this part of the body had failed, as the corpora cavernosa have one artery each and are attached to the pelvis bone. Loosening bone tissue risks damaging blood vessels and losing the corpus cavernosum’s ability to fill with blood.

The idea for the new method was to make an incision in the perineum and perform the operation inside the pelvic bone and, instead of trying to detach the corpora cavernosa from the bone structure, cut a piece of the bone together, tying it to a more forward, on the pubic bone. With this, the corpora cavernosa manage to reach the penis and fill it. They need to be attached to a bone, otherwise penetration would push them in. Definitely.

successful operations

The first patient graced with the new method was a boy who lost his penis to a dog bite when he was still a baby. The reconstructed penis was 8 cm when erect, and another patient, who had a 3.5 cm micropenis, was 9 cm (both measurements when erect). In this case, the surgery was more delicate, as the man had the ability to stand erect, so he had more to lose than other patients.

Penile reconstruction methods, previously, did not allow the erection of the limb, or had risks due to the artificiality of the components.  Rebuilds are now more functional (Image: Charles Deluvio/Unsplash)
Penile reconstruction methods, previously, did not allow the erection of the limb, or had risks due to the artificiality of the components. Rebuilds are now more functional (Image: Charles Deluvio/Unsplash)

Other individuals, who mutilated their penises during psychotic episodes, were also able to take advantage of the operation, as well as a man who lost his penis to cancer. Associated with lack of hygiene, penile cancer represents 2% of malignant tumors in Brazilians, causing the amputation of 500 people per year.

Barroso says he wants to help this part of the population, so he wants to teach the method to other doctors, which requires care and experience — the operation can last up to 9 hours. The last major feat was in a trans man, possible because the clitoris also has 2 corpora cavernosa, almost the same size as in the biologically male body. In this case, the artificial penis was 6 centimeters and functioning perfectly.

Source: International Brazilian Journal of Urology

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