3 FURTHER INVESTIGATION AND TREATMENT
In December 2023, he was referred for solving soft glans syndrome and gradual shrinkage of glans diameter, and an impending prosthesis loss was noted during a physical examination (Fig. 2A). He requested never to touch his implant but just the solution for glans enhancement. A glanography was conducted after a # 19 G scalp needle was fixed at the dorsal aspect of the glans penis with Anterior-Posterior (Fig. 2 B) and lateral view X-ray (Fig. 2 C). A venous complex was demonstrated by bulks of the deep dorsal vein (DDV), two cavernosal veins (CVs, curved arrow) complex (curved arrow in inserted right lower), and the corpus spongiosum (double-headed arrow). Under acupuncture-assisted local anesthesia,11 neither electrocautery nor a suction apparatus was used. The salvage surgery was blueprinted with our proper position to the sub-room above the corpora cavernosa (Fig. 2D). Penile venous stripping was made, entailing the DDV and CVs being stripped, during which 29 ligations were made for the retro-coronal plexus using 6-0 nylon at the exit of every emissary’s vein, venous ligation was performed at the penile hilum with 5-0 nylon. Then, a 3.5 cm longitudinal tunic incision, corporotomy, was performed along the right corpus cavernosum to relocate the implant appropriately, followed by a tunic fashion with 6-0 nylon.
FOLLOW-UP X-RAY
An uneventful postoperative course exists, and he presents us with gratifying glans enhancement diameter. The postoperative glanography was performed (Fig. 2 E, F). An increment of the diameter of the glans penis was 25.0%, diameter from preoperative 30.0mm to postoperative 37.5mm. He drove himself home immediately postoperatively with an uneventful course. He was gratified and shifted from a tractor-trailer driver to a bus driver profession with no necessity of weight withholding and enjoying his harmonious family life.