Current Issue UroToday Int J. 2009 Oct;2(5). doi:10.3834/uij.1944-5784.2009.10.03
Simplified Approach for Correction of Congenital Penile Curvature
INTRODUCTION: The purpose of the present study was to evaluate the long-term results of simplified tunica albuginea plication for correction of congenital penile curvature in adults.
METHODS: Twenty patients with congenital curvature of the penis had surgical correction. The mean age of the patients was 27 years (range, 16-48 years). Nineteen patients had a ventral penile curvature and 1 patient had a ventrolateral curvature. The mean angle of ventral bending was approximately 65° (range, 35°-90°). Detailed history was taken and physical examinations were conducted. Erection was induced by intracavernosal injection of 15 µg of prostaglandin E1 to assess all directions of penile curvature and to determine the angle of deviation. The course of the neurovascular bundles was determined without dissection. Type 2/0 polypropylene plicating sutures were taken through the full thickness of the tunica albuginea. Two to 3 pairs of longitudinal plication sutures placed in both sides of the neurovascular bundles avoided injury of circumflex veins. Plication stitches were made parallel to assure symmetrical adjustment of the curvature. Patients were discharged after 16-24 hours. Follow-up evaluations were done weekly for 8 weeks and annually thereafter. Patients were followed for 2-5 years.
RESULTS: Operative time was 60 to 100 minutes. Successful outcome was achieved in 19 (95%) of the patients. The penis became straight during full and rigid erections and the patients were satisfied with the penile cosmetic feature and sexual intercourse. No patient complained of significant shortening of the erect penis. Recurrence of curvature occurred in 1 patient due to excessive and rigid erections early postoperatively. Three patients complained of uncomfortable sensation due to palpable knots from the polypropylene sutures. One patient had corrective surgery due to coital discomfort caused by the knots. The stitches were removed under local anesthesia with no recurrence of the curvature.
CONCLUSION: The present technique of tunica albuginea plication is simple and not time consuming. It prevents the complications of dissection and mobilization of the neurovascular bundles. Slight shortening of the penis is a disadvantage of the technique. However, it does not interfere with sexual satisfaction.
KEYWORDS: Penile curvature; Congenital; Chordee; Tunica albuginea
CORRESPONDENCE: Dr. Tarek Salem, Rehab City, Modern Cairo, Group 94, Building 4, Flat 11, Cairo, Egypt (tareksalem61@hotmail.com).
CITATION: UroToday Int J. 2009 Aug;2(5). doi:10.3834/uij.1944-5784.2009.10.03
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