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Glanulopexy

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Also Known As

Glans fixation, Glanular fixation, SST deformity correction, Floppy glans correction, Hypermobile glans repair

Definition

Glanulopexy is a surgical procedure designed to fix the glans penis to prevent hypermobility or drooping.1 This technique involves passing a suture into the glans and securing it to the tissue overlying the corpora cavernosa through small incisions on the lateral aspects of the distal penile shaft.2 The procedure is primarily performed to correct glanular hypermobility (GH) or supersonic transporter (SST) deformity, conditions occasionally encountered during or after penile prosthesis (PP) implantation.3 Glanulopexy provides definitive therapy for these conditions by restoring proper anatomical alignment and function of the glans penis, thereby improving sexual function and patient satisfaction.4

Clinical Context

Glanulopexy is clinically indicated in cases of glans hypermobility (GH) or supersonic transporter (SST) deformity, which are conditions characterized by abnormal movement or positioning of the glans penis.1 These conditions are most commonly encountered during or after penile prosthesis implantation, even after appropriate cylinder placement.2 Research suggests potential associations between GH and comorbidities including diabetes (54.5%), hypertension (50%), and history of radical prostatectomy surgery (68%).3

The surgical procedure can be performed either at the time of penile prosthesis implantation (approximately 27.3% of cases) or in a delayed fashion (72.7%).3 The technique involves creating small incisions on the lateral aspects of the distal penile shaft, through which a suture is passed into the glans and secured to the tissue overlying the corpora cavernosa.1 This modification to previously described techniques has demonstrated excellent outcomes in clinical studies.

Follow-up assessments have shown that glanulopexy successfully corrects the anatomic deformity in all patients with the device in situ, with no reported changes in penile sensation.1 The procedure is considered safe and effective, optimizing patient satisfaction without increasing the risk of loss of glans sensation.3 Complications are rare, with only isolated cases of infection requiring device removal reported in the literature.1

Scientific Citation

[1] Ziegelmann MJ, Alom M, Bole R, et al. Modified Glanulopexy Technique for Supersonic Transporter Deformity and Glanular Hypermobility in Men With Penile Prostheses. J Sex Med. 2018;15(6):914-919. DOI: 10.1016/j.jsxm.2018.04.633

[2] Hernandez JC, Gillum R, Saavedra JA, Wang R. Glanulopexy for Glans Hypermobility: Surgical Outcomes on a Rare Condition. J Sex Med. 2019;16(4):S98. DOI: 10.1016/j.jsxm.2019.01.206

[3] Bickell M, Manimala N, Parker J, et al. Floppy Glans Syndrome: Pathogenesis and Treatment. Sex Med Rev. 2016;4(2):149-156. DOI: 10.1016/j.sxmr.2015.12.001

[4] Wilson S, Kohler T, Bole R, et al. Outcomes of Men Undergoing Glanulopexy for Managing Glans Hypermobility. J Sex Med. 2017;14(2):e23. DOI: 10.1016/j.jsxm.2017.01.048

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