Formulas for determining the dimensions of venous graft required for penile curvature correction

Abstract

To evaluate the quantity of penile veins for use as patch material for the treatment of penile curvature, we devised two formulas: from the calculus of applied civil engineering and a diagram from the goniometry of the cadavers' penises, respectively, and the techniques for their application. From March 1995 to July 2003, a total of 65 consecutive patients with penile curvature - 41 men with Peyronie's deformity and 24 with congenital penile deviations - underwent grafting with autologous deep dorsal veins with or without cavernosal veins as patch material. The patched veins required were calculated from the formula (pi)r(2)theta/45 degrees , which is derived from calculus. The tunical incision sector was meticulously performed in accordance with our diagram which is interpolated from seven male cadavers via goniometry and consequently the length of patched veins required was 2 (pi)r(theta)(')/theta. The corporotomy defect was fashioned with the detubularized veins after they were adequately prepared and spliced. In these patients, the average available area of the veins was 4.9 x 2.2 cm(2) (range, 4.5 x 1.8 to 5.6 x 2.4), which seemed adequate in all cases for patching, although 11 of them required two patches. Overall, 21 patients required a modified Nesbit's procedure on the contralateral/ipsilateral tunica to attain a satisfactory penile shape. Because of its anatomical vicinity and its availability as material, the deep dorsal vein associated with the cavernosal vein may play an indispensable role in grafting even with local anaesthesia on an outpatient basis.

Long‐Term Results of Autologous Venous Grafts for Penile Morphological Reconstruction

“…Recently, however, an engineering formula was developed. Thus, both the dimensions and location of the penile curvature correction can depend on a more scientific formula rather than just relying on the trial and error principle (Hsu et al, 2006). During surgery, it is not difficult to prevent sinusoidal bleeding.…”

“…Similarly, a smaller but substantial cavernosal vein was stripped. The deep dorsal vein was spliced side by side when necessary to a length of 2πrθ′/θ, where θ′ is the incision sector in degrees, θ is the curvature angle, and r is the radius of the penile shaft in erection (Hsu et al, 2006). Similarly, the cavernosal vein was managed if necessary and feasible.…”

1124 The Egydio geometrical procedure for managing penile curvature using a single relaxing incision: A single-centre experience with 330 patients

“…The Egydio's procedure is based on simple geometric principles and uses mathematical calculations to measure the precise dimensions of the required graft [3,6]. Other authors have also incorporated formulas using goniometric data to extract the exact shape of the tunical defect [8]. Our technique to use a Penrose loop to measure the tunical defect length and width simplifies graft preparation.…”

Surgical Management for Peyronie's Disease

“…Egydio et al34 have championed taking advantage of geometric principles to determine the exact location and shape of the tunical incision that should be employed. Hsu et al35 have employed exact formulae derived from calculus and goniometry to define meticulously the dimensions of the graft required for tunical application. The supposed benefit of these approaches is that the dimensions of the graft may be determined prior to tunical incision, which may save surgical time if a separate team prepares the graft.…”