Introduction and Objectives
The angle formed by the axis of the penis and abdominal surface is called an angle of erection. Initially, it is around 45 degree, gradually with age, rising to an angle of 90 degree. In this way, oblique position of the penis is similar to the axis of the vagina and naturally facilitates its penetration. The available literature did not give the description at of the situation in which the low angle of erection would impede normal intercourse and forced affected by this anomaly to seek for help urologist. Horizontal stability during erection is provided by an extremely strong concrescence corpores cavernoses and pubic bones. Axial stability is given by the ligaments. The intersection of those ligaments is a part of the operation of extending penis (Burman's method). The adverse effects are the increased angle of erection and the risk of loss stability of penis. The aim of this paper is to present the procedure for correction “hypererection” and the discussion of the possibilities of treatment probably not rare anomaly that makes sexual life difficult or impossible.
Material and Methods
Over the past three years in the Department of Urology of Medical Academy in Gdansk we have reported three men complaining too little angle of erection (the penis significantly close to abdominal wall). It make sexual relations impossible. Problems consisted of difficulties in the penetration of vagina and pain during the intercourse reported by both partners. Using the experiences learned from mentioned “penis extension” sick were proposed intersection the ligaments of penis anticipating about possible adverse consequences In subarachnoid anesthesia by semi-circle, 6–7 cm long cutting we reached the base of the penis and the surface and pubic symphisis. We intersected the ligaments. We separated the 4 cm base of the penis. Into created space we temporarily inserted Redon's drain.
The first patient, KT 24 years, resident of Lublin, gave the information by telephone that he is satisfied with the effect of the operation and refused to control. Since this was the first case of this condition we did not ensure preoperative documentation. Patient, GP 19 years, is satisfied of effect. During clinic control in spite of visual stimulation did not achieve a full erection. Then he changed the address because he begun study. Patient, MO 32 years, married, is satisfied with the result of surgery. We have photographic documentation before and after surgery. We also present photos of his surgical treatment.
When examining the three reported cases, we believe that correcting surgery should be performed at pharmacologically caused erection. Midoperationaly assessment of the possibility of increasing the angle of erection better control treatment and help to avoid the risk of loss stability of penis.
© 2009 European Association of Urology. Published by Elsevier Inc. All rights reserved.