Technique recreates penises “from scratch” by SUS and promises to return an active sex life

It was midnight on an ordinary day in 2012 when João*, 61 years old, woke up to the barking of dogs.

He got out of bed to find out if anyone was trying to get into his house, located in the rural area of ​​a city in Bahia, and even saw the bandits from afar, in the dark. That’s when one of them fired a single shot, hitting the farmer’s groin and severing part of his penis.

The story only had a happy ending at the end of September this year, when he underwent penile reconstruction surgery performed by a Brazilian urologist.

“I was defective. I couldn’t even urinate. I almost died, but now everything is going to change”, he said, shortly before the intervention. One day after the process, which started at 3 pm and ended around 10 pm, João said he didn’t feel any pain and couldn’t wait to remove the bandages. He was discharged two days after the surgery, without any complications or the need for a blood bag.

In all, seven people have already undergone the innovative procedure created by the team of physician Ubirajara Barroso, head of the urology service at the Prof. Edgard Santos from the Federal University of Bahia (UFBA), where he is also coordinator of the urology discipline. Six of the patients underwent Total Bodies Mobilization (TCM) through the Unified Health System (SUS), João being the only one to perform the surgery privately.

The specialist explains that only part of the penis is outside the body, having an extension, not visible, inside the man. On average, the part we see corresponds to only 2/5 of the organ, while the other 3/5 are fixed in the pelvis, guaranteeing the erection. Barroso’s idea was relatively simple: pull the inside out.

“What we do in surgery is to detach this portion of the corpus cavernosum from the bone and bring everything to the surface. It’s like an iceberg: it has a small portion above water and a large portion below water. The small penis is just the tip of this iceberg, so we remove the ‘in the water’ part and put it on the surface”, he says.

Despite the simplified theory, the procedure had never been done in the world. The first time the specialist was able to prove the technique worked was in 2019, in a boy who had his penis ripped off by a dog at 8 months old.

The child bitten by the dog

The case, which made the police pages in mid-2000, took place in Itapicuru, about 215 km from Salvador, Bahia. The family dog ​​ripped off the boy’s penis, which had the organ completely amputated. At the time, the mother was advised to perform a sexual reassignment surgery on the baby, so that he would become female. She didn’t accept.

Around the age of 11, André* underwent his first surgery with the doctor Ubirajara Barroso. Using a technique prior to TCM, the specialist from Bahia managed to recover the boy’s urethra, which was urinating through an orifice. It was the second surgery of this type performed in Brazil and it was successful. “We did a kind of skin graft to make it look like male genitalia,” he explains.

However, André’s hormones were already kicking in with puberty. “He masturbated by touching the perineum, an area close to the anus, under the scrotum. And then, when he was almost 18 years old, the idea came to try”, says the doctor.

In the case of the young man, it would be difficult to place a penile prosthesis, since there was not much to be reused as a base. In addition, an inflatable prosthesis, which he would have to activate when he wanted to have sex, costs around R$ 40,000 and the surgery is not performed by the SUS.

Finally, the skin used to cover the prosthesis is from another part of the body (such as an arm, for example) and does not have nerve endings like a sexual organ – which makes it impossible to enjoy masturbation.

TMC uses existing penile tissue on the inside, detaching it from the bone and replacing it a little more outside. Because it is made with this tissue, which is capable of erection, a prosthesis is not necessary. In Jorge’s case, the penis ranged from zero to eight centimeters. “He guarantees that he feels pleasure in masturbation and soon he should try penetration, because he knew he was ‘triggering’ a relationship”, he says.

Still, doctors questioned whether what the boy felt was really an orgasm, as he had never had a penis to compare it to. It was in this way that they found a second patient.

The second to undergo the technique was Moacir*, who has psychiatric disorders. In a psychotic break, he ripped off his own penis, leaving only about three inches. Years after the crisis and under control, he went to the doctor in an attempt to recover the organ.

Today, after the procedure, the penis is 12.5 cm long and is capable of providing pleasure similar to the organ without intervention, according to the doctor. “He also masturbates calmly, says it’s like before and is super happy”, he sums up.

Penis and micropenis cancer

The first to try penetration was Carlos*, a married man who suffered from penile cancer and, because of the disease, lost four centimeters of the organ.

According to the supervising physician of the Penis Cancer Discipline of the Brazilian Society of Urology (SBU), José de Ribamar Rodrigues Calixto, there is an expectation that TCM will be increasingly used in cases related to this disease.

Depending on the stage of the tumor, it may be necessary to remove the entire phallus, but in less advanced cases of cancer, amputation of half of the organ may be sufficient.

“There is an estimate that the man can penetrate with eight centimeters of external penis in erection. Even if you amputate half of the penis, it will hardly be that big to be able to penetrate again. In addition, many times we have to reconstruct the urethra in the perineum and they urinate sitting down”, says Calixto.

After the surgery, Carlos was about 11.5 centimeters and has already resumed his sex life. Barroso reveals that he confirmed feeling orgasm like before. “He is even penetrating over the top of the partner, which is a difficult penetration due to the greater angulation. In other words, it’s not just intercourse with a woman ‘on top’, which is easier, but with him on top”, says the creator of the technique.

The fourth challenge for the Bahian medical team was to manage not only to enlarge, but also to make a case of micropenis thicker. “It was the most challenging case and the one that took me the longest,” he says.

Among the difficulties was the fact that Reinaldo* already had a well-formed penis, even though it was incapable of penetration, but with regular appearance and other features. “A guy with a penis like that is desperate, all cases involve (feeling of) responsibility, but this one I couldn’t let go wrong”, he says.

Despite the difficulty, the patient is not only doing well but is dating and has intercourse with penetration. According to the doctor, it went from 2.5 centimeters to 9.5 centimeters, in addition to the increase in width.

The representative of the SBU pointed out that the urologist Ubirajara Barroso has already given lectures to the associated physicians so that the procedure can be carried out in other states. So far, only one TCM surgery has been performed outside Bahian soil, the fifth in Brazil. This is a patient from Rio Grande do Sul, from Porto Alegre.

At the time, Barroso traveled to Rio Grande do Sul and performed the surgery along with a colleague. As he is not a patient of his, the doctor does not clearly remember the current length of the penis, but claims that the man gained eight centimeters right after the surgery.

The sixth patient was the only one to undergo a modified procedure: instead of removing the inner part of the penis, the inner part of the clitoris was removed, in addition to going through the thickening process.

“Incredible as it may seem, the anatomy of the clitoris is identical to the anatomy of the penis, it has the same cylindrical corpora cavernosa, only smaller. It’s like a miniature penis, sort of folded into itself,” he explains.

Some hormones also facilitated the thickening of Marcelo*’s penis, which now measures 7.1 centimeters. “Obviously, it doesn’t have the slightest extension because the penis is bigger than the clitoris, both externally and internally. So that’s why the trans man will also have a little more limitation ”, he says.

Even so, the surgery allowed Marcelo to have, for example, the experience of urinating standing up. Barroso used part of the internal mucosa of the mouth to make a urethra that passed through the old clitoris to its tip, allowing him to urinate like an ordinary man.

Another surprise in this case was confirming that Marcelo can masturbate and have a different form of pleasure than before. “The woman masturbates in a certain way, but the man masturbates taking it.

Today Marcelo* is masturbating. He said “look, it’s another orgasm”. We know that orgasm is also very much in the head, so it is not a question of saying that men have more or less orgasms than women. But he is feeling much more pleasure”, says the doctor.

post-surgical

The most recent patient was João, the victim of bandits in Bahia. He is already back home, but he was instructed not to try sex with his wife, with whom he has been married for 35 years and has four children – two men and two women, who gave the surgery to their father. He was the only one to go through the service privately and not through the SUS.

The inventor of the technique advises that the patient wait at least two months to have intercourse. Otherwise, however, recovery is quick and he can go back to work about 15 days later.

Hospitalization, counting pre and post surgery, usually takes two to three days. This period may increase if you need urethral reconstruction, but the surgery usually takes about eight hours.

None of the men needed a blood bag or had any kind of complication. When the technique began to be studied, there was a fear that it would mainly affect the penile artery, in addition to the great vascularity of the intimate region.

“That’s why the procedures had never been thought of, because mobilizing that bone would cause a lot of damage to the vessels. What we did was a technical modification, but one that allows the procedure to be performed inside the bone and we also took advantage of this bone portion to fix and guarantee the erection”, says the urologist.

penis enlargement

Although the technique manages to increase and even thicken the male sexual organ, Barroso only intends to adopt the procedure for those diagnosed with micropenis, penile cancer, mutilation or gender reassignment.

According to the professional, most men who believe they have a small penis usually do not, and surgery is unnecessary. “These cases were never treated in a way that significantly gained in size, but in personal life”, he says.

Currently, Brazil accounts for more than 500 cases of penile amputation per year and there is no concrete data on the number of trans men who intend to undergo reassignment surgery.

Barroso’s queue, according to his account, is already in the thousands, especially since the procedures are carried out by the SUS. The professional reinforces that he is in contact with several Brazilian urologists and announces that, soon, he should recover the sex life of a São Paulo native.

*All names have been changed so as not to expose patients