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Sexual Medicine
Penile Suspensory Ligament Division for Penile Augmentation: Indications and Results
Chi-Ying Li, Oliver Kayes, Phillip D. Kell, Nim Christopher, Suks Minhas and David J. Ralph,
St. Peter's Andrology Centre and Institute of Urology, 48 Riding House Street, London W1P 7PN, UK
Accepted 13 January 2006. Available online 31 January 2006.
Referred to by: Is Penile Enlargement an Ethical Procedure for Patients with a Normal-Sized Penis?
Abstract
Objective
This study assessed the management of patients requesting penile length enhancement by division of the penile suspensory ligament.
Methods
From September 1998 to January 2005, 42 patients with a variety of etiologies were included; all underwent division of the penile suspensory ligament. The outcome was assessed objectively based on increase in flaccid stretched penile length (SPL) and subjectively using the rates of patient satisfaction.
Results
The mean increase in SPL was 1.3 ± 0.9 cm (range, −1 to +3 cm), with the addition of a silicone spacer placed between the pubis and penis giving a better outcome (p < 0.05). The overall patient satisfaction rate was 35% but lower in the group with penile dysmorphic disorder at 27%.
Conclusion
Division of the penile suspensory ligament or other augmentation techniques may increase penile length but usually not to a degree that satisfies the patient. Men with penile dysmorphic disorder often have unrealistic expectations regarding the outcome of surgical intervention and should be encouraged to seek psychological help primarily, with surgery reserved as the last resort.
Keywords: Penile suspensory ligament; Penile lengthening; Penile dysmorphic disorder
Majority of men getting PE surgery unsatisfied 
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