This is a very interesting congenital deformation. Let me be frank, I had never heard of this deformation before my first total penis shaft rotation patient came. The books say it's a very rare deformation, with most surgeons never seeing a single total penile shaft rotation in their lifetime. I do not think it is very rare, because after the first patient who came to me, I wrote this deformation on my website www.kozmetikcerrahi.com and 3 more cases followed. I operated on two of these patients. Compared to the world average (it is written in the books that many surgeons do not see a single case, we can say that the world average is zero) is a pretty good number. I think there are more patients with this deformation; but people probably don't know that this is a correctable deformation and they manage the condition all their lives. So what is this total penis shaft rotation, and what is its significance?

Total penile shaft rotation is the development of the body tissue (erectile tissue) and/or skin of the penis in a sideways manner. In other words, only the skin may be crooked, or the body tissue of the penis may be completely turned sideways. See the drawing above...

The problem in this deformation is that either only the skin or the penile body tissue is completely sideways. It is relatively easy to correct this if only the skin is semi-developed; but if the body tissue of the penis is semi-developed and attached to the pelvis in this way, then a different procedure is required. This deformity has a different significance for those who ask for penile enlargement surgery. Why? I explain below...

If the body tissue of the penis is congenitally attached to the pelvis, the penis stays in the lateral position. It's like someone turned the penis 90 degrees sideways and stayed that way. In this case, what needs to be done for correction is to completely (100%) cut the suspensory ligament that attaches the penis to the pelvis, free the body tissue of the penis from the environment, straighten it by turning it 90 degrees and sew it back to the pelvis. In other words, you cut the suspensory ligament completely, correct the position of the penis and re-sew the suspensory ligament. It is recommended to use special non-melting and knitted stitches during this stitch. Knots should never slip and be completely locked, so braided surgical nylon sutures should be used, not straight surgical nylon sutures.

So, what is the importance of these cases for those who have penis enlargement surgery?

The most frequently asked question by patients who are going to have penis enlargement is the possibility of having a problem with the cutting of the suspensory ligament. Even though we say that they will not have any problems with the cutting of the suspensory ligament, this fear has been inserted into the minds of the patients because of the ridiculous false information circulating on the internet. . Patients constantly ask if they will have a problem with the cutting of the suspensory ligament, and if necessary, they want to know if this ligament can be sutured again. This is exactly what is done in cases of total penile shaft rotation. The hanging tie is cut and sewn again. So, it's possible. But let me be frank, none of the cases where we made an extension so far have asked for the hanging tie to be replanted. First, you won't have a problem cutting the suspensory ligament; Secondly, such a thing is completely unnecessary, I have never received such a request..

Since patients with total penile shaft rotation are sideways, this situation is corrected by surgery while peeing sideways. As long as they learn that this is a problem that can be corrected with surgery, they consult a doctor.

Op. Dr. Oytun İdil

(Plastic aesthetic and reconstructive surgeon)

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