Abstract Introduction Introduction: Penile elongation surgery includes various procedures aimed at increasing penile length, with applications ranging from anatomical indications such as micropenis and post-surgical shortening in Peyronie’s disease to psychological concerns like penile dysmorphophobia. Suspensory ligament release is among the most frequently performed techniques. However, outcomes are variable, and complications-such as loss of penile angle, recurrence of shortening, and erectile dysfunction-remain concerns. There is no clear consensus on the optimal extent of ligament release. Objective Objective: To quantify the anatomical changes in penile length and pubopenal angle following 50% and 100% division of the suspensory ligament in cadaveric specimens, in order to inform surgical decision-making. Methods Methods: From May to August 2024, 34 male cadaveric specimens underwent staged division of the penile suspensory ligament. Measurements were taken at baseline, after 50% ligament division, and after complete (100%) division. Outcomes included gently stretched penile length (PLg, simulating flaccid state), fully stretched penile length (PLft, simulating erect state), and the pubopenal angle. Paired t-tests were used to analyze differences between the stages. Results Results: Mean PLg increased from 13.71 cm at baseline to 14.15 cm after 50% release, and to 14.56 cm after full release (p 0.001 for both). Mean PLft increased from 14.42 cm to 14.90 cm and then to 15.33 cm, also statistically significant (p 0.001). The pubopenal angle increased from 58.62° to 70.07° at 50% release, and to 79.37° after full release (p 0.001). Comparisons between the 50% and 100% stages showed additional statistically significant gains in both PLg (p = 0.01) and PLft (p = 0.009). Conclusions Conclusion: Partial (50%) division may optimize both length gain and angle change, allowing for a more favorable position of the penis without compromising function. Further clinical studies are needed to validate these findings in live patients, particularly regarding erectile function, satisfaction, and long-term outcomes. Disclosure No
Lohasomboon et al. (Mon,) studied this question.