{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T05:45:51Z","timestamp":1791870351219,"version":"4.3.4"},"reference-count":25,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,5,31]],"date-time":"2026-05-31T00:00:00Z","timestamp":1780185600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,5,31]],"date-time":"2026-05-31T00:00:00Z","timestamp":1780185600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universidade Federal Da Bahia"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World J Urol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Dissatisfaction with penile girth is an increasingly recognized concern among men and can cause psychosocial distress despite normal anatomy. Existing augmentation techniques are often associated with limited durability or procedure-related morbidity. This study presents the initial clinical experience with a novel autologous penile girth augmentation technique that combines dartos fascia and tunica vaginalis flap (DART-VAG).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a prospective, non-randomized interventional study evaluating the DART-VAG technique. Penile length and circumference were measured preoperatively and at a 6-month follow-up. Psychosexual outcomes were assessed in a subset of patients using the Degree of Distress due to size concerns (DDC) questionnaire and the Male Genital Self-Image Scale (MGSIS). Postoperative complications and patient satisfaction were prospectively recorded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thirty-two adult men underwent penile girth augmentation with DART-VAG between November 2021 and August 2025. No intraoperative complications occurred. Mean penile length increased from 6.2\u2009\u00b1\u20091.67\u00a0cm to 8.7\u2009\u00b1\u20091.46\u00a0cm (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), and mean circumference increased from 9.4\u2009\u00b1\u20091.08\u00a0cm to 11.2\u2009\u00b1\u20091.15\u00a0cm (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). No patient reported loss of achieved dimensions, and all patients (100%) reported satisfaction at 6 months. Wound dehiscence occurred in four patients (12.5%), most of whom were managed conservatively; one patient (3.1%) required surgical drainage of a scrotal hematoma. Total DDC scores decreased significantly after surgery, and MGSIS improved in specific domains.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>DART-VAG is a feasible technique for penile girth augmentation, providing significant gains, acceptable complications, and favorable psychosexual outcomes. Larger studies with longer follow-up are needed to confirm our findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00345-026-06474-2","type":"journal-article","created":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T08:01:12Z","timestamp":1780300872000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["DART-VAG: initial clinical experience with a novel autologous technique for penile girth augmentation"],"prefix":"10.1007","volume":"44","author":[{"given":"Ubirajara","family":"Barroso","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabela Alvim","family":"Barroso","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geraldo Ramos","family":"Ribeiro Filho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucas Teixeira E.","family":"Aguiar Batista","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco Aur\u00e9lio Silva","family":"Lipay","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,31]]},"reference":[{"key":"6474_CR1","doi-asserted-by":"publisher","first-page":"1253","DOI":"10.1093\/asj\/sjz154","volume":"39","author":"G Sharp","year":"2019","unstructured":"Sharp G, Oates J (2019) Sociocultural influences on men\u2019s penis size perceptions and decisions to undergo penile augmentation: a qualitative study. 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