I am Dr. Kurbatov Dmitry, Professor of Urology and Surgery, Moscow, Russia.
I have been practicing Urogenital Surgery and Andrology for more than 30 years.
I was the student of the Best Genitourinary Surgeon in the World Professor Sava Perovic.
This page presents some of my scientific and practical interests.
Autologous fat transfer is used usually to increase the circumference of the penis (penile widening), or implantation of the PLGA scaffold. Recent years, hyaluronic acid injections have become popular.
These methods have disadvantages: unpredictable results, lack of aesthetics, fat and scaffold resorption, scars, a long rehabilitation. Moreover, hyaluronic acid is very expensive and short-lived.
Since 2019, I have been using a new safe method for penile widening — subcutaneous injections of the PowerFill liquid synthetic implant (South Korea), officially allowed in Russia for enlarging phalloplasty.
PowerFill is a suspension of biodegradable microgranules from polylactic acid (PLA), dissolved in saline solution, which introduces subcutaneously along the penile shaft. Then microgranules dissolve, stimulating neocollagenogenesis, i.e. the growth of its own connective tissue in this part of the body.
The main difference between PowerFill and other fillers is the long time results — 2-3 years. At the same time, the newly formed tissue will feel tight and elastic, without limiting the erection, and the skin of the penis remains absolutely sensitive and mobile.
For penile lengthening we use ligamentolysis (ligamentotomy).which results in penile lengthening primarily in flaccid state. The principle of the operation is based on dissection eliminating the physiological curvature of the penis by dissection the supporting ligament of the cavernous bodies with a change in their angle of fixation and moving forward, followed by V-Y skin plasty.
The changes in the angle of cavernous bodies fixation after ligamentolysis
Ligamentolysis with V-Y skin plasty of the peno-pubic angle.
After the ligament dissection, a closed cavity is formed, which I recommend filling with various synthetic material (silicone strips, testicular prosthesis), in order to prevent cavernous body retraction after surgery. In this case, the use of various extenders in the postoperative period is not required. In case of combination the Ligamentolysis with V-Y skin plasty of the peno-pubic angle the result of penile elongation is + 3-4 cm.
If patient has a hidden penis in fatty tissue, visually and functionally reducing the length of the organ, suprapubic lipectomy/liposuction (removal of fat) can be performed.
Elongating Circular Corporoplasty is a technically more difficult operation, but it allows to achieve a Real Penile Lengthening of 2-4 cm. If combine Corporoplasty with Ligamentolysis it is possible to get the penile lengthening in erect state of 3-6 cm. The result of elongation depends on the extensibility and elasticity of the spongiose body of the urethra and the neurovascular bundle.
The operation includes the following steps:
- Mobilization of the urethra and neurovascular bundles.
- Circular incision (corporotomy) of tunica albuginea without the cavernous tissue damage (usually 1-2 corporotomies).
- Grafting with collagen biomembrane — corporoplasty.
The scheme of the corporoplasty.
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