Auxetic Expansion of the Tunica Albuginea for Penile Length and Girth Restoration Without a Graft: A Translational Study

INTRODUCTION: Several conditions can cause penile length and girth loss. Surgical techniques have been used to restore these penile alterations in patients with severe erectile dysfunction during penile prosthesis implantation. One technique uses multiple small incisions in a mesh pattern (similar to a skin mesh) with satisfactory curvature correction without using a graft, however, this technique does not allow simultaneous increase in penile length and girth. AIM: To identify a new surgical technique that increases both the length and girth at the same place on the corpora cavernosa (CC), allowing a simultaneously longitudinal and transverse increase of the tunica albuginea. METHODS: A sheet with a star-shaped perforation was created using a mathematical model to allow a longitudinal and transversal increase in the material. Two previously published penile model simulators, with and without deformity, were used to test the mechanical modification of this incision pattern in the CC. MAIN OUTCOME MEASURE: The effect of the incisions pattern on the geometry of the CC simulator. RESULTS: The star-shaped incision (auxetic) simultaneously increased the length, girth, and volume of the CC simulator. This auxetic technique could correct any penile deformity, re-establishing the original penile anatomy. The new auxetic incision is only a conceptual and experimental technique awaiting clinical evidence. CONCLUSION: The data presented here show that the auxetic technique successfully increases both the length and girth at the same place on the CC simulators, opening a new potential solution to correct challenging cases of complex penile deformities and to restore volume loss. Miranda A, Auxetic Expansion of the Tunica Albuginea for Penile Length and Girth Restoration Without a Graft: A Translational Study. Sex Med 2021;9:100456.