Penis Thinning: Cause and treatment of hourglass deformity

Afinamento peniano em ampulheta
If you have noticed changes in your sex organ and you are worried about penile thinning, it is time to seek information and a specialist to evaluate your condition, as surgery may be necessary. 
 

The thinning can have several causes and determining it correctly is the secret for the patient to receive the most appropriate treatment, in order to recover, mainly, the functionality of the penis.

In the blog that you will read below, we will understand why the penis loses caliber and how it is possible to solve the deformity so that the man has penetrative capacity again.

 

Cause of penile thinning

What causes the thinning of the penis is the formation of fibrosis in the inner part of the tunica albuginea.

Fibrosis is nothing more than a scar, and the tunica albuginea is the membrane that covers the male member. 

When the tunica albuginea undergoes some kind of patch, there is a loss of elasticity at the site of the scar. Thus, when the penis is pressurized, the site(s) where there is fibrosis(s) may present a curvature or a thinning.

 

How do fibroses occur?

There are some causes for the appearance of penile fibrosis.  

One of them is Peyronie's Disease, a condition we always cover in this blog. It is generated by trauma and/or microtrauma to the penis, which trigger an inflammatory and healing process.

Another possibility is after the man undergoes radical prostate surgery. Sometimes the penis fails to have nocturnal erections, which are common and healthy. As a result, there is less blood oxygenation within the penile tissue, a favorable environment for triggering fibrosis. Poor oxygenation can also happen when a man suffers from erectile dysfunction.

When the patient suffers a fracture during sexual intercourse, the tunica albuginea can be torn and the fractured site is susceptible to scarring.

Diabetes is also associated with the formation of fibrosis in the medium and long term, as this comorbidity favors the inflammatory process and reduces blood flow.

 

Types of penile thinning

There are four types of penile thinning caused by fibrosis. Know what they are:

 

Total thinning of the penile shaft

This is when the tunica albuginea as a whole loses its elasticity. Thus, the thinning does not appear in a single point, but in the entire shaft, which configures a more serious case, as it affects the entire penis.

Afinamento Total

Figure 1. Thinning throughout the penile shaft.

 

Partial thinning

Cases of partial penile thinning vary. Sometimes the base is preserved and the deformity appears from the middle to the front or from the tip to the front. In other situations, what thins is the base, keeping the tip or half of the limb intact.

Afinamento na Base ou na Ponta

Figure 2. Partial thinning (either at the base, or at the tip).

 

Indentation thinning

This type of thinning appears on only one side of the penile shaft. It can appear anywhere on the penis, but always on one side. 

Afinamento em Indentação

Figure 3. Indentation thinning.

 

Hourglass thinning

Hourglass thinning is when fibrosis occurs at one or more specific points on the circumference of the penis, leaving it with a shape that resembles the object. 

Afinamento em AmpulhetaFigure 4. Hourglass thinning (Hour-glass deformity).

 

Thinning and decrease in penis size

Penile thinning may be accompanied by a reduction in penile size, with/without curvature.

Can we consider it a Peyronie symptom? The answer is yes, because the disease does not necessarily have penile curvature. 

But not everything is Peyronie. The penis can thin and it is not the disease, but the phimotic ring, another condition that must be evaluated by the urologist.

 

Penile thinning and erectile dysfunction

As I said before, the thinning is caused by fibrosis in the tunica albuginea. This membrane keeps the blood pressurized inside the penis through a veno-occlusive mechanism that allows erection. 

The process of penile thinning, when diffuse, is commonly associated with erectile dysfunction

In the thin segment, the penis loses its vertical resistance, that is, it bends in that place at the time or during penetration, which can worsen the problem.

 

Treatment for penis thinning

The treatment consists of a surgery to perform the tissue expansion of the area(s) affected by fibrosis and eventually the placement of a prosthesis. The procedure will help to restore the caliber and axial rigidity of the male organ. 

Expansion is performed on the tunica albuginea, where multiple relaxation cuts are made for the tissue to expand.  

Although the cuts are made in the vertical direction, as the expansion system is perpendicular to the direction of the cut, everything is done individually. 

To determine the quantity, size and position of the necessary cuts, the surgeon needs to know in depth the anatomy of the deformity of each patient and outline the best surgical strategy.

When the case requires the placement of a prosthesis, the expansion of the caliber also aims to create space to receive it. In this sense, the so-called adjuvant maneuvers, which aim to expand the tissues to the limit of the nerves, vessels and urethra, must be combined with the implantation of the prosthesis. 

Thus, the result is more likely to be a penis with the characteristics it had before, or as similar to it as possible.

If you suspect penile thinning, we hope this blog is the first step to start taking care of yourself. 

The next step is to contact my team through the form that is here on the website or via WhatsApp. We will help you resolve the deformity and ensure confidentiality and safety in all care.

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To learn more about the work developed at the clinic by Dr. Paulo, check out:

Dr. Paulo Egydio

MD, PhD, Dedicado no Tratamento da Doença de Peyronie, Pênis Curvo e Implante de Próteses Penianas. Doutor em Urologia pela USP, CRM 67482, RQE 19514. - Vencedor do Debate do Sobrevivente da AUA em 2019.





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