Comparison of implant methods for penis enlargement
Authors: Aguilar I.E. , Knigavko O.V. , Choi D.M. , Sangjin K. 
Published: May 2023

Male dissatisfaction with the penis size is the most common manifestation of penile dysmorphophobia. Despite the diversity of penis enlargement methods a single safe technique that fully satisfies patients has not yet been developed.The aim of this work is to compare the results of a combined operation on installation of a silicone implant or a collagen matrix impregnated with autologous stem cells with simultaneous ligamentotomy to increase the length and circumference of the penis.In 2017–2022 there were performed penis enlargement surgeries in 2 centers. In Public Non-Profit Organization Of The Kharkiv District Council «Kharkiv Regional Clinical Center Of Urology And Nephrology Named After V.I.Shapoval (Kharkiv, Ukraine) 38 patients from Ukraine and Poland were operated by Professor Knigavko O.V. with implantation of a porous Max Pol matrix (manufactured by Dersmithson, M.D. Choi), and in the “Mexico phalloplastic center” (Mexico city, Mexico) by Dr. Aguilar I.E. implantation of non-absorbable silicone implants in 36 patients was perfomed. The results of penis enlargement were evaluated in the early (2 months) and long-term (6 months) terms.While implanting a silicone implant the majority of the patients – 31 (86.1%) are satisfied with the result, 27 (75%) patients mention an improvement in sexual life, 31 (86.1%) also mention an increase in their own self-sufficiency. At the same time, some patients mentioned the following complications: 2 (5.6%) patients mentioned displacement of the silicone matrix, 1 (2.8%) patient mentioned prolapse of the matrix, 1 (2.8%) patient mentioned a decrease in erection (which did not improve after removal of the matrix), in 1 (2.8%) case the silicone implant had to be removed due to the fact that the patient did not liked the appearance.While using a collagen-like matrix made of polymerized polylactic acid impregnated with own stem cells in 38 patients, we haven’t seen any complications that caused the removal of the matrix. However, 5 (13.2%) patients required additional polylactic acid gel injections between 6 and 36 (97.4%) months to optimize the shape or volume of the penis. 34 (89.5%) patients mentioned an improvement in the sexual function and sexual sensations of their partner, harmonization of relationships in a couple, and 36 (97.4%) men – an increase in a sense of self-sufficiency.Thus, modern implants can improve the size and appearance of the penis, improve the quality of sexual life and the feeling of self-sufficiency in operated men. The use of silicone implants is simpler, almost does not require specific rehabilitation after surgery, however, in a small part of patients prolapse of the prosthesis and dissatisfaction with the final result are present. Most of operated patients were satisficed results of silicone implant. The use of a polymer matrix impregnated with own stem cells requires a special laboratory, more time for preoperative and postoperative rehabilitation, however, it is more physiological and can be considered as a standard for safe penis enlargement.