الفهرس 
The efficacy of suspensory ligament release via penopubic Z plasty during penile prosthesis insertion in improving patient{u2019}s sexual satisfaction
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Abstract
Background: Penile length reduction is considered one of the chief complaints of men undergoing prosthesis implantation, which is eventually confirmed by a substantial portion of reputable researchers in the scientific context of penile prosthesis surgery. This complaint either being real or self-inflected mental impression, shouldn{u201F}t be ignored as it is easily reflected on the patient{u201F}s sexual satisfaction and hence his sexual quality of life. Objectives: Assessment of the efficacy and safety of the suspensory ligament release and the use of peno-pubic 2Z3 plasty in maintaining and/or enhancing the penile length after penile implantation surgery, and evaluating its clinical role in the improvement of the patient{u201F}s overall sexual satisfaction compared to the simple conventional method of prosthesis insertion. Materials and methods: Between the period of August 2018 and April 2020, sixty-one patients complaining of medical refractory erectile dysfunction (ED) were randomized into two groups; thirty patients underwent conventional penile prosthesis implantation (PPI) using ventral penoscrotal midline incision, while 31 patients underwent PPI via penopubic Z plasty incision along with concomitant suspensory ligament release, dorsal phalloplasty and pubic fat lipectomy, ventral phalloplasty was also added in indicated cases. Patients were followed up for three months for the following parameters including; postoperative penile length measurements and calculation of length variation from those measured preoperatively, early and delayed complications encountered and sexual satisfaction assessment using IIEF, SHIM and EDITS scores. Also a late follow-up after 6 months was done using another 5-item sexual satisfaction questionnaire, in addition to self-developed questions for assessment of satisfaction regarding the perceived penile length and girth on a likert scale