An original mininvasive corporoplasty technique for penile curvature without circumcision

Published: September 26, 2022
Abstract Views: 2232
PDF: 932
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

Objective: We describe an original minimally invasive penile plication technique with scrotal or infrapubic access, not requiring circumcision, for penile curvature of different severity and types. This technique can be used to correct both congenital and acquired curvatures, mono or bidirectional deformities.
Materials and methods: Between 2012 and 2018 we treated 134 patients suffering from congenital curvature (33) and acquired curvature from Peyronie's disease (101). The average curvature was 62.2° (± 30.4°). Preoperative evaluation included prostaglandin E1 injection with photographic documentation and measurement of penile angulation, administration of IIEF- 15, vasoactive penile Doppler ultrasound, analysis of thermal and vibratory sensitivity with Genito-Sensory-Analyzer (GSA) and assessment of nocturnal penile stiffness with Rigiscan, performed twice, for a detailed evaluation of patient’s erectile function. Scrotal access was performed in patients with dorsal and/or lateral penile curvature; the infrapubic access was performed in patients with ventral curvature. After preparation and incision of Colles’ fascia, penis was partially degloved and an original plication technique called "binary corporoplasty" was performed at the site or sites established at preoperative assessment, with non-resorbable synthetic multifilament (Premicron®) suture.
Results: Complete correction of penile curvature was achieved in 96.8 % of patients. No major complications were reported, and no patients suffered worsening in erectile function or in penile sensitivity. The average shortening of convex side was 1.65 cm (± 0.7 cm) and all patients report easy intercourse after correction. The average time of surgery was 46 minutes (± 11 min) and all procedures were performed as a day-hospital or ambulatory settings, with local anesthesia and light sedation. Overall satisfaction rate is 96%.
Conclusions: This is a simple and rapid technique that perfectly corrects even the most severe and complex penile curvatures. In comparison to traditional techniques, such as Nesbit procedure, this technique is associated with low morbidity, a very low recurrence rate and a great aesthetic results. Aesthetic and functional patients’ satisfaction was excellent.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

Citations

Makovey I1, Higuchi TT, Montague DK, Angermeier KW, Wood HM Congenital penile curvature: update and management. Curr Urol Rep. 2012;13:290-7. DOI: https://doi.org/10.1007/s11934-012-0257-x
Nesbit RM. Congenital curvature of the phallus: report of three cases with description of corrective operation. J Urol 1965; 93: 230–2. DOI: https://doi.org/10.1016/S0022-5347(17)63751-0
Levine L, Rybak J, Corder C, Farrel MR. Peyronie's disease plaque calcification prevalence, time to identification, and development of a new grading classification. J Sex Med. 2013;10:3121-8. DOI: https://doi.org/10.1111/jsm.12334
Riedl CR, Plas E, Engelhardt P, Daha K, Pflüger H. Iontophoresis for treatment of Peyronie's disease. J Urol. 2000;163:95-9 DOI: https://doi.org/10.1016/S0022-5347(05)67981-5
Bolgeo T, Di Matteo R, Gardalini M, Gatti D, Maconi A, Boccafoschi C. Quality of life of patients with La Peyronie's disease undergoing local iontophoresis therapy: A longitudinal observational study. Arch Ital Urol Androl. 2022 Mar 29;94(1):75-79. DOI: https://doi.org/10.4081/aiua.2022.1.75
Carson CC1, Levine LA. Outcomes of surgical treatment of Peyronie's disease . BJU Int. 2014;113:704-13. DOI: https://doi.org/10.1111/bju.12565
Hatzimouratidis K, Eardley I, Giuliano F, Hatzichristou D, Moncada I, Salonia A, Vardi Y, Wespes E. EAU guidelines on penile curvature. Eur Urol. 2012;62:543-52 DOI: https://doi.org/10.1016/j.eururo.2012.05.040
Rajmil O, Arrús J, Fernandez M, Sarquella J, Ruiz-Castañé E, Blasco A. Sensory changes after surgical correction of penile curvature. Int J Impot Res. 2009; 21:366-71 DOI: https://doi.org/10.1038/ijir.2009.42
Devine CJ Jr, Horton CE. Surgical treatment of Peyronie’s disease with a dermal graft.
J Urol 1974; 111: 44–9. DOI: https://doi.org/10.1016/S0022-5347(17)59886-9
Ebbehoj J, Metz P. New operation for ‘krummerik’(penile curvature). Urology 1985; 26: 76–8. DOI: https://doi.org/10.1016/0090-4295(85)90264-X
Kelâmi A. Congenital penile deviation and its treatment with the Nesbit-Kelâmi technique. Br J Urol 1987; 60: 261–3. DOI: https://doi.org/10.1111/j.1464-410X.1987.tb05496.x
Udall DA. Correction of 3 types of congenital curvatures of the penis, including the first reported case of dorsal curvature. J Urol 1980; 124: 50–2. DOI: https://doi.org/10.1016/S0022-5347(17)55288-X
Montague DK Correction of chordee. The Nesbit procedure. Urol Clin North Am. 1986;13:167-74 DOI: https://doi.org/10.1016/S0094-0143(21)01539-1
Yachia D. Modified corporoplasty for the treatment of penile curvature. Urol 1990; 143: 80–2. DOI: https://doi.org/10.1016/S0022-5347(17)39871-3
Garaffa G, Sacca A, Christopher AN, Ralph DJ. Circumcision is not mandatory in penile surgery. BJU Int 2010; 105: 222–4. DOI: https://doi.org/10.1111/j.1464-410X.2009.08763.x
De Rose AF, Ambrosini F, Mantica G, Zero E, Banchero R, Terrone C. Prepuce-sparing corporoplasty as a safe alternative for patients with acquired penile curvature. Arch Ital Urol Androl. 2020; 92:182-185 DOI: https://doi.org/10.4081/aiua.2020.3.182
Alei G, Letizia P, Alei L, Massoni F, Ricci S: New surgical technique for ventral penile curvature without circumcision. BJU Int 2014; 113: 968–974 DOI: https://doi.org/10.1111/bju.12539

How to Cite

Rossi, A., Alei, G., Viscuso, P., Tufano, A., Frisenda, M., Mantica, G., Bove, P., Leonardi, R., De Dominicis, M., & Calarco, A. (2022). An original mininvasive corporoplasty technique for penile curvature without circumcision. Archivio Italiano Di Urologia E Andrologia, 94(3), 334–338. https://doi.org/10.4081/aiua.2022.3.334