Kontakt
Praxis für UrologieDr. med. Aref El-Seweifi
Forum Zehlendorf
Teltower Dam 35
D-14169 Berlin
Deutschland
Tel.: +49 30 804 90 950
Fax: +49 30 804 90 951
info@masculine.de
| Enlargement of the scrotum |
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The size of sex organs has been paid attention since the beginning of the history. This can be followed on the walls of the temples of ancient Egypt and Greece. The length of the penis and its girth and the volume of the scrotum are symbols of masculinity and powerful sexual ability. This fact affects the self-esteem of a man and his confidence and his sexual behavior and influences the women in many cases during the establishment of a new relationship. The attention to the scrotum and the rational size of it in comparison to the penis and genital area have been given attention recently. The development of testicular prosthesis have allowed the enlargement of the scrotum through the implantation of such prosthesis. The implantation of the new semi lunar prosthesis or the usual testicular prosthesis has allowed to give a new look for the organ without the feeling of having an extra numerary testicles. The scrotum is a part of the developmental elements of the genital landmarks confined to the perineum of the man. It is made of very lax skin, muscle (the detrusor) and fascia. It constitutes the covering of the testicles and its other parts including the veins, the arteries and the nerves of the region. The muscle of the scrotum and its fascia have a continuity with those of the wall of the abdomen and extend in the groin. The nerves and blood supply of the scrotal contents is called the testicular supply, while the blood and nerve supply of the skin is related to the superficial nourishment of the skin of the groin and perineum. Understanding this fact is important for the enlargement of this part of the body using the plastic reconstructive surgery. The muscle of the scrotum is contractile. Some times it is hyperactive to push the testicle into the groin and even inside the cavity of the abdomen if the entries to the abdomen are opened. This happens in particular in cold weather resulting in reduction of the scrotal volume. The coverings of the testicle may also be opened to the abdominal cavity. If the pressure inside the later becomes high, some of its contents may descend to produce a lump called the hernia. --
-- Who qualifies for the operation? Man may be born by a congenitally underdeveloped scrotum which may be due to malformation of the testicles or malformation of the genital elements constituting the two halves of the scrotum. The traumatic or surgical loss of the scrotum may lead also to its inequality or its loss. I usually see the patient at least twice before the operation to get an idea about him and to avoid operating patient who suffer under Phobodysmorphobia. These patients are psychologically fixed to be aware of certain parts of their body and think that this part is not cosmetically appealing or it does not suite their other body parts. These patients will never be satisfied of any result and should be excluded to be fatherly referred to a psychologist. How does the operation work? Scrotal enlargement means increasing the volume of the sac as much as possible but according to a certain size related to the testicles to some extent. The size of the testicles as measured per ultrasonic is important because each one has to fit inside the half moon shaped prosthesis without strangulation of its nourishment or pressure on its cells and reproductive elements. The prosthesis are then produced according to the size of each testicle. The scrotal sac is incised either in the middle (raphe) or on both sides. I prefer the incision in the middle because this will give the best cosmetic appearance and allows a scrotal elongation and a scrotal push back if this is necessary. The testicles are then delivered out side. The sterile prosthesis are wrapped with a special smooth mesh and is adjusted to the testicles with multiple sutures. The muscle of the scrotum is incised to weaken its action without injuring its blood supply. The structures are returned to the sac and fixed to its bottom. The sac is closed in layers and a sterile bandage is fixed on the wound. The operation is done either in local anesthesia or mask intubation on outpatient basis. Documentary pictures are taken before and after the operation. If scrotal enlargement is required it is done through a V-Y plasty that have very good results and simulates a push back procedure. My study on the blood supply of the scrotum and the testis proved that they are not affected after the implantation of the prosthesis neither are the reproductive ability or the endocrine function of the testis. The enlargement of the scrotum is a selective elective procedure that does not improve erection or sexual physical performance but also does not worsen it. The operation has no effect on the blood supply or hormonal production of the testis or the development or production of the sperms. The blood supply of the skin of the scrotum will stay not affected and hence the texture, the color and the appearance of the sac, Provided that the prosthesis are will measured, designed and placed. If the scrotum is too small or lost, I reconstruct it using flaps from the upper inner part of the thigh to be rotated and diverted with its blood supply to the scrotal area and fixed there. How to prepare for the operation? Please see The chapter on the preparation of the patient.
Frequently asked questions (FAQ): --
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