120 Successful cosmetic reduction corporoplasty and scrotoplasty in a patient with the complaint of self-perceived too large penis and scrotum

Cosmetic reduction of a normal penis. A 48 year-old male with normal and harmonious sex life and normal erectile function wanted a significant size reduction of his penis. Actually, he had been thinking of and wishing a penile and scrotum reduction for the past 10 years. Since no surgical technique was available in the literature to perform such a reductive phalloplasty, we sought to set up an innovant technique of corporoplasty. A six months evaluation included two successive psychological evaluations and seven medical consultations to urologists. This patient had no psychological disorders and no co-morbidity. A serious preoperative informed consent was obtained from the patient. Preoperative measurements of the girth and length of the penis were 10cm and 11cm in the flaccid state, respectively, and 15.5cm and 16cm, respectively, at erection. The first step was a complete degloving of the penis, with dissection of the Buck fascia and the dorsal neuro-vascular bundle, to have a good exposure and to avoid any neuro-vascular lesion. Then the reduction in girth was done by a lateral longitudinal albuginea resection on the penile part of the two corpora cavernosa. A running suture was carried out to close the corpora, with a non-resorbable mono-filament material. Afterwards the reduction in length was done by a plication technique. A modified «Tom Lue Dot plication» was used by applying this technique to the 4 meridians (dorsal and ventral). Finally, a scrotoplasty was done to achieve a harmonious and proportional aspect of the genitalia.