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.
Penile Widerning
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.
Ligamentolysis
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 + 2-3 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.
Corporoplusty
Elongating Circular Corporoplasty is a technically more difficult operation, but it allows to achieve a Real Penile Lengthening of 3-4 cm. The result of elongation depends on the extensibility and elasticity of the cavernous tissue, 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.
For corporoplasty, I use a collagen graft from the bovine pericardium. This material is safe and converted into your own collagen within 1.5 years.
The ECC is effective if the penis is not circumcised, because the circumcised penis has no skin on the penile shaft after cavernous bodies elongation. The foreskin is needed to close this wound.
ECC is not a routine technique and the risks of the complications are certainly present. Among the complications may be hematoma, infection, penile contracture, erectile dysfunction (ED).
3-4 weeks after surgery the patient has to start using a vacuum pump and extender to stretch the cavernous tissue of the penis, as the grafts are soft and contract. The pump should be used not less than 6-12 months and more if necessary, to consolidate the result, prevent contracture and ED.
In order to get the necessary rigidity to the penis to prevent penile and graft contraction, as well as if there is the risk of ED developing or ED already present, I recommend combining the operation of corporoplasty with the implantation of semi-rigid prostheses. Penis elongation is achieved immediately to the maximum, and in the future a pump and an extender will not be needed.
After 1-2 years it is possible to replace the semi-rigid implant with an inflatable 3-component one, and if desired, it is possible to simultaneously perform longitudinal corporplasty with grafting to increase the penile thickness.
I respond to requests by email.
My e-mail: professorkurbatov@gmail.com