Penile Reconstruction & Phalloplasty

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What is lichen sclerosus or balanitis xerotica obliterans?

Lichen sclerosus (LS) or balanitis sclerotic obliterans (BXO) is a disease that affects the skin of the genitals. In male patients it can affect the foreskin, the glans penis and the distal urethra. In the most severe cases, all the skin of the penis and all the urethra are affected. It is still not well understood why some patients develop LS but it is now suspected that the maceration of the skin caused by the pooling of urine, recurrent skin infections might be linked to the formation of lichen sclerosus. Most of the patients affected by LS are also suffering from diabetes mellitus and have low levels of serum testosterone.

The skin affected by LS becomes thicker, inelastic and tends to become of a typical whitish colour. As the skin is inelastic, it does not stretch during erections and it cracks during sexual activity. The cracks are source of pain, itching and bleeding. When affected by LS, the foreskin becomes inelastic and unretractable in a clinical picture also known as phimosis; in the more severe cases, the inner layer of the foreskin may fuse with the mucosa of the glans. 

In case of phimosis, it is impossible to retract the foreskin to clean the glans and hygiene becomes consequently poor. It is therefore important to correct surgically the phimosis not only to improve sexual activity but also to reduce the risk of recurrent urinary tract infections and of developing penile cancer, which is strongly associated with poor genital hygiene. If the lichen sclerosus affects the urethra, this can manifest as a narrowing of the urethral tube and urination can become very challenging.

Why Choose Giulio

Giulio is a veteran surgeon with 15 years of experience in the field of Andrology and Reconstruction. He is also one of the largest penile prosthesis implanters in Europe, as well as the surgeon who performs the largest number of procedures for the correction of complex cases of Peyronie's disease. He has been invited to lecture and perform surgery in 21 different countries, in 6 different continents.


Penile prosthesis implants last year


Complex Andrological procedures every year


Phalloplasties over his career