Treatment Process: Outpatient or Inpatient, Anaesthesia & Procedure Duration

Outpatient or Inpatient?

The distinction between outpatient and inpatient treatment primarily concerns the length of stay at the medical facility. With an outpatient procedure, the patient leaves the practice or clinic the same day; overnight monitoring is not required. With an inpatient stay, the patient remains for at least one night — generally when the procedure is complex, carries an elevated risk, or requires close postoperative monitoring.

The decisive factors in choosing between the two are the type of procedure and its associated risk profile, the patient's general state of health, the chosen anaesthesia method, and the individual's capacity for aftercare — in other words, whether adequate care and recovery at home can be ensured. Most procedures performed at our practice — penis enlargement, girth enhancement, scrotal tightening, penile implants — are carried out on an outpatient basis; the patient can generally be discharged home, accompanied, on the same day as the surgery. For more complex procedures, inpatient monitoring may be advisable, which we discuss and plan individually in such cases.

Anaesthesia

Anaesthesia refers to the targeted, controlled elimination of pain sensation and is chosen based on the procedure, its duration and the patient's preference. All forms of anaesthesia are administered by specially trained anaesthesiologists or — in the case of local anaesthesia — by the surgeon themselves, and require continuous monitoring of heart rate, breathing and blood pressure.

Local anaesthesia numbs only a narrowly defined area through local injection of an anaesthetic; the patient remains fully awake. It is suitable for very small, superficial procedures, but is often not sufficiently comfortable on its own for procedures in the intimate area.

Regional anaesthesia eliminates sensation in a larger part of the body without affecting consciousness. Typical examples are spinal anaesthesia or epidural anaesthesia in the lumbar or pelvic region.

Twilight sleep — medically known as sedoanalgesia or moderate sedation — is the technique used most often at our practice for procedures in the intimate area. The patient is placed, through a combination of pain relief and calming medication, into a relaxed, semi-conscious state. They remain responsive but experience the procedure as pleasant, have little to no memory of it afterwards, and feel no pain. Compared with general anaesthesia, twilight sleep offers the advantages of a faster wake-up, a shorter recovery period and a more favourable side-effect profile — all while offering a high level of patient comfort.

General anaesthesia renders the patient completely unconscious and is indicated for larger or more complex procedures — for example, penile implant surgery combined with additional measures. Breathing and vital signs are mechanically monitored and supported throughout the entire anaesthetic.

Procedure Duration

Procedure duration refers to the actual operating time — that is, the time from the first incision to wound closure. It does not include preparation, induction of anaesthesia, the recovery period, or postoperative monitoring, which significantly extend the total time spent at the practice or clinic.

Procedure duration varies considerably depending on the type and complexity of the technique. Smaller procedures such as an isolated frenulotomy or scrotal tightening typically take 30 to 60 minutes. A combined penis lengthening with girth enhancement typically takes one to two hours. Implantation of a hydraulic penile implant requires one to two hours, depending on the surgeon's experience and the patient's anatomy.

Procedure duration is relevant not only for organizational planning — it also influences the choice of anaesthesia method, the risk profile, and the postoperative recovery time. Patients are always informed during the consultation about the expected duration of their specific procedure, including the total time they should plan for their visit to the practice.