Augmentation Phalloplasty for Acquired Penile Shortening: A Systematic Review of Techniques, Outcomes, Patient Satisfaction, and Limitations.
Level 4 - case-series / case-control
Systematic review of predominantly Level 4 observational studies and case series
PubMed 31831387 · doi:10.1016/j.jsxm.2019.11.260
What was done
A systematic review following PRISMA guidelines searched Medline/PubMed, Scopus, and Cochrane databases from 1990 to 2018. It evaluated augmentation phalloplasty techniques, penile length gains, complications, and patient-reported satisfaction in non-transgender adult males presenting with acquired penile shortening.
What was found
Twelve articles covering 931 patients and 8 primary surgical procedures met inclusion criteria. Most included studies were Level 4 evidence (83%) with moderate risk of bias (92% scored 6 on the Newcastle-Ottawa Scale). Penile length gain ranged from 0.6 to 6.4 cm across studies, though measurement methods were inconsistent. Overall complication rates ranged from 0% to 50%. Patient satisfaction was evaluated in 10 studies (7 using validated instruments), with satisfaction rates ranging from 77% to 100%. Data limitations precluded determining a single superior surgical technique.
Why it matters
This review compiles the available surgical evidence for acquired penile shortening, highlighting current length enhancement outcomes and the wide variability in post-surgical complications.
Limits
The underlying evidence is limited to low-level retrospective case series with moderate risk of bias. There was substantial heterogeneity across surgical techniques, an absence of standardized pre- and post-operative measurement protocols, and inconsistent reporting of complications.
Cited by
- supports Penile lengthening surgeries have very high complication rates.