Dorsal Phalloplasty and Monsplasty for Lengthening

Shaeer, O.

penile prosthesis, penile implant, length, elongation, Dorsal phalloplasty, Monsplasty

Dissatisfaction with length is among the complaints of a subset of patients following penile prosthesis implantation (PPI). Adjuvant techniques for elongation can help alleviate this complaint but add to the operative time and extent of intervention, possibly reflecting on infection rates. This video presents two minimally invasive techniques for enhancing visible penile length by revealing the base of the penis. Both techniques can be performed alongside PPI, in the same session. “Dorsal phalloplasty” [1] tacks the peno-pubic junction inwards to the pubic symphysis, using one or more permanent braided sutures, placed through the same peno-scrotal incision. “Tape Monsplasty” [2] on the other hand elevates the pubic fat pad altogether cephalad. This is performed through a 1cm incision overlying one anterior superior iliac spine (ASIS), where a 5 mm-wide nonabsorbable tape is inserted blindly on a long forceps, down to the base of the penis and then up to the contralateral ASIS, to exit through another 1 cm incision. The tape is pulled upwards, pulling up the pubic fat pad, then tied to both ASISs. More than one tape can be inserted through different planes, if required.

1. Shaeer O, Shaeer K, Rahman IA. Dorsal Phalloplasty to Preserve Penis Length after Penile Prosthesis Implantation. Sultan Qaboos Univ Med J. 2017 Feb;17(1):e27-e30. doi: 10.18295/squmj.2016.17.01.006. Epub 2017 Mar 30. 
2. Shaeer OK. Shaeer's Technique: A Minimally Invasive Procedure for Monsplasty and Revealing the Concealed Penis. Plast Reconstr Surg Glob Open. 2016 Aug 29;4(8):e1019. doi: 10.1097/GOX.0000000000001019. eCollection 2016 Aug. PubMed