Simultaneous penile prosthesis implantation and penile lengthening surgery using the reverse V-Y technique: a report of two cases

Background: For men with erectile dysfunction who are not responding to conventional treatment, penile prosthesis implantation is seen as a bright future. Many patients worry that their penile length may be reduced after surgery. Several simple adjuvant procedures are implemented to enhance phallic size concomitantly during penile implants. In this study, we describe two patients who had simultaneous penile lengthening surgery and three-piece penile prosthesis implantation. Cases: The two patients were 55 and 62 years old, respectively. Both had severe erectile dysfunction that did not respond to oral medication. They underwent three-piece penile prosthesis implantation (Titan® Touch, Coloplast, USA). During the surgery, the corpora cavernosa in these cases were measured at 19 and 15 centimeters; therefore, we chose the length of cylinders plus rear-tip extenders at 18 + 0.5 centimeters and 14 + 1 centimeters, respectively. The reverse V-Y technique was applied concomitantly, which allowed 2.5 centimeters of penis lengthening in both cases. No major complications were recorded. At the sixth month of follow-up, the patients reported feeling highly satisfied. Conclusions: Through two cases of penile prosthesis implantation combined with penile lengthening surgery, it was initially recognized that this is a feasible and safe technique, resulting in greater patient satisfaction.

Penile prosthesis implantation; Penile lengthening; Erectile dysfunction

[1] Salonia A, Boeri L, Capogrosso P, Corona G, Dinkelman-Smit M, Falcone M. EAU guidelines on sexual and reproductive health. 2026. Available at: https://uroweb.org/guidelines/sexual-and-reproductive-health (Accessed: 30 March 2026).
[2] Köhler TS, Munarriz R, Parker J, Bettocchi C, Hatzichristodoulou G, Martins FE, et al. Penile prosthesis for erectile dysfunction: recommendations from the 5th International Consultation on Sexual Medicine. Sexual Medicine Reviews. 2025; 13: 144–171.
[3] Hakky TS, Suber J, Henry G, Smith D, Bradley P, Martinez D, et al. Penile enhancement procedures with simultaneous penile prosthesis placement. Advances in Urology. 2012; 2012: 314612.
[4] Sansalone S, Garaffa G, Djinovic R, Egydio P, Vespasiani G, Miano R, et al. Simultaneous penile lengthening and penile prosthesis implantation in patients with Peyronie’s disease, refractory erectile dysfunction, and severe penile shortening. The Journal of Sexual Medicine. 2012; 9: 316–321.
[5] Frederick DA, Reynolds TA, Smart NL, Garcia JR, Puts DA. I lost my number, can I have yours? Body image satisfaction with sexually dimorphic traits is associated with men’s dating anxiety and confidence. Evolution and Human Behavior. 2026; 47: 106876.
[6] Nelson CJ, Clayton AH, Lew-Starowicz M, Balon R, Eltantawy W, Glina F, et al. Psychiatric disorders, psychopharmacology and sexual dysfunction from the fifth International Consultation on Sexual Medicine (ICSM 2024). Sexual Medicine Reviews. 2026; 14: qeag017.
[7] Caso JR, Myers MD, Wiegand L, Rodriguez A, Hann S, Carrion R. Phalloplasty and penile implant surgery. Current Urology Reports. 2009; 10: 475–477.
[8] Falagario UG, Piramide F, Pang KH, Durukan E, Tzelves L, Ricapito A, et al. Techniques for penile augmentation surgery: a systematic review of surgical outcomes, complications, and quality of life. Medicina. 2024; 60: 758.
[9] Seminara G, Meduri L, Leuzzi M, Antonini G, Aversa A. Penile rehabilitation after surgery for prostate cancer: an umbrella review on traditional approaches and novel perspectives. Journal of Clinical Medicine. 2026; 15: 4688.
[10] Deveci S, Martin D, Parker M, Mulhall JP. Penile length alterations following penile prosthesis surgery. European Urology. 2007; 51: 1128–1131.
[11] Nguyen Hoai B, Pham Minh Q, Nguyen Cao T, Sansone A, Colonnello E, Jannini EA. Data from 14,597 penile measurements of Vietnamese men. Andrology. 2021; 9: 906–915.
[12] Wessells H, Lue TF, McAninch JW. Complications of penile lengthening and augmentation seen at 1 referral center. The Journal of Urology. 1996; 155: 1617–1620.