Research Article

Venous Ligation: A Novel Strategy for Glans Enhancement in Penile Prosthesis Implantation

Figure 1

Schematic illustration and photos of this penile enhancing surgery. (a) Illustration showing new insight into penile venous anatomy from lateral view in the human penis. The glans penis composed of sinusoids through which blood drains independently to the deep dorsal vein (DDV), cavernosal veins (CVs), and para-arterial veins. The venous plexus were ligated at retrocoronal sulcus (multiple smaller cross). DDV and CVs were subsequently ligated close to penile hilum (large cross). The radius of glans was assessed (double arrow). (b) Ongoing surgery demonstrating the visibility of the retrocoronal plexus (asterisk) can be enhanced via squeezing the glanular sinusoids after a circumferential approach was performed. Segment of 1-2 cm was stripped while the ligation number may be as many as 29. (c) The proximal segment of DDV (clamped by mosquito hemostat, arrow) and CVs was freed and ligated close to penile hilum.
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