{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T13:21:11Z","timestamp":1780579271827,"version":"3.54.1"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,1,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The penile suspensory ligament (PSL) plays a significant role in penile support and erection and its injury or congenital absence may result in functional impairment of erectile function.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Aim<\/jats:title>\n                  <jats:p>To describe the diagnosis and surgical repair technique for PSL abnormalities and overall outcomes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A comprehensive review of the literature was performed to understand the anatomic relevance of the PSL and historical management of PSL defects. A contemporary method for PSL repair is described using a transverse infrapubic incision with placement of midline anchoring (non-absorbable braided) sutures between the tunica albuginea (TA) and symphysis pubis to correct penile position and instability.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Outcomes<\/jats:title>\n                  <jats:p>Surgical success defined as degree of penile curvature and penile stability for sexual intercourse as well as patient and partner satisfaction rates were reviewed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Though limited in number, available case series in the literature indicate a success rate between 85-100%, and more recent reviews fall in the 85-91% range. Patient satisfaction rates vary from 82-88%, but some series included patients with penile dysmorphic disorder and Peyronie\u2019s disease, which are known to have higher dissatisfaction rates related to the underlying etiology itself. In patients with venogenic erectile dysfunction (ED), resolution was 100% but de novo ED occurred in 3-5%; these cases were all successfully managed medically.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Clinical Implications<\/jats:title>\n                  <jats:p>This review addresses the diagnosis of PSL abnormalities and demonstrates a simple but effective repair technique to significantly improve erectile stability in men with acceptable risk.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Strengths and Limitations<\/jats:title>\n                  <jats:p>This is a comprehensive review of the available research on PSL abnormalities that outlines its diverse patient presentation and a systematic method to diagnosis and repair PSL defects. The patient satisfaction rates are reasonably high but given the relatively rarity of this entity, larger longitudinal multi-institutional studies are required to further elucidate risks of de novo ED, penile shortening, and functional outcomes over the long-term.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>PSL repair using permanent anchoring sutures or a fascial graft between the pubic symphysis and the TA of the corpora cavernosa is a safe and efficacious way to restore an important part of the penile suspensory apparatus that helps stabilize the penis during erection for normal sexual function.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jsxmed\/qdae166","type":"journal-article","created":{"date-parts":[[2025,1,3]],"date-time":"2025-01-03T13:21:58Z","timestamp":1735910518000},"page":"175-183","source":"Crossref","is-referenced-by-count":3,"title":["Penile suspensory ligament: anatomy, function, and clinical perspectives of its repair"],"prefix":"10.1093","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4628-4059","authenticated-orcid":false,"given":"Wen","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Urology, Holmesglen Private Hospital , Moorabbin 3189, Victoria,","place":["Australia"]},{"name":"Male Infertility and Andrology Fellow Sexual Medicine, , Melbourne 3000, Victoria,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ross","family":"Calopedos","sequence":"additional","affiliation":[{"name":"Macquarie University Hospital , Sydney 2113, NSW,","place":["Australia"]},{"name":"The Lyx Institution Department of Urology, , Madrid 28006,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gideon","family":"Blecher","sequence":"additional","affiliation":[{"name":"Department of Urology, Holmesglen Private Hospital , Moorabbin 3189, Victoria,","place":["Australia"]},{"name":"Monash University Department of Surgery, School of Clinical Sciences, , Melbourne 3800, Victoria,","place":["Australia"]},{"name":"The Alfred Hospital Department of Urology, , Melbourne 3004, Victoria,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2169-5740","authenticated-orcid":false,"given":"Christopher","family":"Love","sequence":"additional","affiliation":[{"name":"Department of Urology, Holmesglen Private Hospital , Moorabbin 3189, Victoria,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,1,3]]},"reference":[{"issue":"6","key":"2025010313214811800_ref1","doi-asserted-by":"publisher","first-page":"413","DOI":"10.1007\/BF01653133","article-title":"The suspensory ligament of the penis: an anatomic and radiologic description","volume":"20","author":"Hoznek","year":"1998","journal-title":"Surg Radiol Anat"},{"key":"2025010313214811800_ref2","doi-asserted-by":"publisher","first-page":"2436","DOI":"10.12659\/msm.901926","article-title":"Visualization of penile suspensory ligamentous system based on visible human data sets","volume":"23","author":"Chen","year":"2017","journal-title":"Med Sci Monit"},{"issue":"5","key":"2025010313214811800_ref3","doi-asserted-by":"publisher","first-page":"402","DOI":"10.1111\/j.1464-410x.1979.tb02896.x","article-title":"Abnormalities of the suspensory ligament of the penis as a cause for erectile dysfunction","volume":"51","author":"Pryor","year":"1979","journal-title":"Br J Urol"},{"issue":"1","key":"2025010313214811800_ref4","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1111\/j.1464-410X.2007.06551.x","article-title":"The penile suspensory ligament: abnormalities and repair","volume":"99","author":"Li","year":"2007","journal-title":"BJU Int"},{"issue":"1","key":"2025010313214811800_ref5","doi-asserted-by":"publisher","first-page":"6323","DOI":"10.1038\/s41598-019-41652-w","article-title":"Cosmetic penile enhancement surgery: a 3-year single-Centre retrospective clinical evaluation of 355 cases","volume":"9","author":"Littara","year":"2019","journal-title":"Sci Rep"},{"issue":"1","key":"2025010313214811800_ref6","doi-asserted-by":"publisher","first-page":"e4728","DOI":"10.1097\/GOX.0000000000004728","article-title":"Anatomical study of the penile suspensory system: a surgical application to micropenis","volume":"11","author":"Danino","year":"2023","journal-title":"Plast Reconstr Surg Glob Open"},{"issue":"1","key":"2025010313214811800_ref7","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1186\/s12610-023-00202-1","article-title":"Suspension of the penis - 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