New surgical technique for ventral penile curvature without circumcision

Abstract

Objectives• To describe and report on our variant of penile corporoplasty, the 'double-breasted' corporoplasty, with penoscrotal and infrapubic access not requiring circumcision.• The medicolegal aspects of treatment are also discussed. Patients and Methods• Between February 1995 and October 2012, double-breasted corporoplasty was performed in 93 patients with congenital ventral penile curvature.• Preoperative assessment comprised RigiScan monitoring, prostaglandin E1 injection with photographic documentation and measurement of penile angulation, administration of the International Index of Erectile Function-5 (IIEF-5) questionnaire, and biothesiometry up until 5 years ago when it was substituted with the Genito Sensory Analyser for testing sensitivity.• Dorsal infrapubic access was used in the patients with ventral curvature. After preparation and incision of Colles' fascia, the penis is degloved and double-breasted corporoplasty is performed at the site established at preoperative assessment. The tunica albuginea is prepared, an incision is made, and the cavernous tissue is isolated from the albuginea to obtain two flaps that are then overlaid and sutured asymmetrically with interrupted 2-0 polyglactin 910 (Vicryl ® ) sutures. After the free edge of the albuginea is sutured with a running polyglactin 910 suture, a non-absorbable monofilament and uncoated suture made of polypropylene (Premicron ® ) suture is placed at the point of maximum traction. Results• Complete correction of penile curvature was achieved in 96% of patients; recurrence occurred in 4%.• No major complications were reported, nor were there neurovascular lesions or change in erectile function.• Palpable subcutaneous irregularities at the site of the corporoplasty, without functional or aesthetic impairment, were reported by 35% of patients.• There was no change in the appearance of the penis as circumcision was not performed and the residual scar was barely noticeable as it was hidden in the infrapubic fold.• The corporoplasty technique can adequately restore the patient's psychophysical integrity, making it, from a medicolegal perspective, one of the most reliable procedures in the surgical repair of penile curvature. Conclusions• This original technique is associated with low morbidity, a low recurrence rate and excellent aesthetic results.• The results show that it is safe and effective. When indicated for the surgical treatment of penile curvature, the choice of the technique satisfies the criteria of diligence and prudence for the surgeon's conduct.

An original mininvasive corporoplasty technique for penile curvature without circumcision

“…Results and satisfaction rates are similar to the Nesbit procedure. In the early 90's, we described a new technique with a different surgical access (at the base of penis rather than distally) and a different type of corporoplasty (doublebreasted corporoplasty) (17). These minimally invasive surgical accesses allow the rapid resumption of sexual activity, have excellent aesthetic results, and allow to avoid circumcision and total penis degloving.…”

Three Anatomical Levels: Possibilities To Decrease Invasiveness Of Reconstructive Surgery For Congenital Penile Curvature

“…Some authors after circumferential subcoronal incision make degloving by a very meticulous separation of the tunica dartos and Buck's fascia, which enables the preservation of blood supply into the distal part of the penile skin and in consequence preserves the foreskin [ 3 , 13 ]. If penile curvature is situated at the base of the penile shaft, the same prepuce-saving effect can be achieved with the penoscrotal approach [ 3 , 15 ], dorsal infrapubic approach [ 15 ] or the longitudinal incision at the proximal part of the penile shaft [ 8 , 9 ] are used.…”

The effectiveness of penile curvature treatment by cavernous body rotation and plication of the tunica albuginea

“…Meanwhile, the probability of penile shortening, the effectiveness of its straightening, and postoperative numbness of the glans penis did not differ significantly in both groups [ 8 ]. There are also modifications without circumcision, which have a similar high efficiency (96%) and comparable risks of complications [ 9 , 10 ].…”