Abstract Introduction Penile girth enhancement with autologous fat is attractive due to its biocompatibility. The main limitation of standard Coleman fat grafting is high fat resorption, often leading to asymmetry, nodularity, or loss of volume. Stromal vascular fraction (SVF)-enriched fat may improve graft survival by promoting angiogenesis, modulating inflammation, and via other paracrine effects. Objective This study evaluated the safety and clinical outcomes of SVF-enriched penile fat grafting performed with a novel SVF-extraction device. Methods This retrospective study included 50 patients undergoing penile girth augmentation with SVF-enriched fat and 38 age-matched controls receiving standard Coleman fat grafting. All men had normal erection or mild erectile dysfunction. The procedure involved liposuction, non-enzymatic SVF extraction and mixing SVF with microfragmented (SVF-fat group) or standard Coleman technique, followed by circumferential graft injection avoiding the corpora cavernosa. Penile girth and length (flaccid and erect) and International Index of Erectile Function (IIEF-5) scores were measured at baseline and at 1, 3, 6, and 12 months. Patients with mild erectile dysfunction (n=10 and n=17 in the Coleman fat and SVF-fat groups, respectively) also completed the full IIEF questionnaire. Satisfaction was graded on a 1–5 scale at 12 months. Results Baseline characteristics did not differ between groups (p0.05). At 1 month, all the metrics were comparable across groups (p0.05). At 12 months, the SVF-fat group showed significantly greater volume retention for all penile dimensions (p0.001, Bonferroni-adjusted). The largest effect was recorded for flaccid girth in the SVF fat group (mean +2.8 cm, ≈82% retention) versus +1.6 cm (≈50%) in the Coleman group. Other mean changes were (SVF-fat versus Coleman fat): erect girth +1.9 cm versus +1.0 cm; flaccid length +1.0 cm versus +0.6 cm; erect length +0.8 cm versus +0.4 cm. No deterioration in erection was observed. Among patients with mild erectile dysfunction, the SVF-fat group showed significantly higher erectile function IIEF domain scores (26.2/30 points versus 23.9 in the control group; p0.001), and 15 of 17 patients returned to normal erection. Satisfaction was higher in the SVF-fat group (4.2/5 versus 3.7/5; p=0.013). Minor wound infections occurred in 2 patients in each group and resolved with oral antibiotics. Conclusions SVF-enriched penile fat grafting provided stable volume retention, high safety, great patient satisfaction, and significant improvement in erectile function in men with mild erectile dysfunction. Disclosure No
Sforza et al. (Mon,) studied this question.