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Objective To review the mechanisms and patient outcomes for men presenting with abnormalities of the penile suspensory ligament (PSL) and their correction. Patients and Methods We conducted a retrospective review of a total of 118 patients who presented with a variety of PSL abnormalities that necessitated surgical repair from 1993 to 2018. The patients mean (range) age at presentation was 29 (12–60) years with a mean (range) follow up of 8 months (3 months–12 years). The diagnosis was made clinically, often with a history of penile instability, pain or curvature/torsion, which was confirmed on artificial erection testing. Nocturnal tumescent testing and magnetic resonance imaging were used where necessary. The surgical repair was performed by placing non‐absorbable sutures between the tunica albuginea of the penis and the symphysis pubis. Postoperative outcomes were reported in the clinic by direct questioning and a repeat of the investigations above when patients were unsatisfied with the result. Results The aetiologies and surgical indications in the 118 patients included: abnormality subsequent to sexual trauma (n = 66); congenital curvature of penis and/or congenital absence/laxity of the ligament (n = 37); Peyronie's disease (n = 8); and venogenic erectile dysfunction (ED; n = 7). A good surgical result, as defined by stabilization and straightening of the penis and a return to normal sexual function, was achieved in 85% of the patients and 82% were very satisfied with the outcome. Complications included long‐term ED in four patients. Conclusion Abnormalities of the PSL are uncommon and often subtle, but with the appropriate diagnosis, a good cosmetic and functional result is usually achievable.

SUMMARY A simple, convenient, and accurate method of detecting and measuring even the smallest degree of cyclodeviation with the help of two special major amblyoscope slides is described. Routine use of these slides in the investigation of all paralytic squints to detect and measure cyclodeviation is suggested. This will prove useful in the correct diagnosis and in the adequate management of a case of cyclovertical muscle palsy.The importance of the detection and measurement of cyclodeviation in all cases of paralytic squint is being increasingly realised, but it has not yet been a routine practice with all orthoptists and strabismologists because of the absence of a handy and at the same time accurate method of testing. Of the various methods commonly employed to detect cyclodeviation the Maddox double prism test and the Bielschowsky apparatus cannot measure it. The Maddox wing measures cyclodeviation only for near vision. The Maddox rod placed in a trial frame is often used to measure the defect at different distances and in different gaze positions, but a slight tilt of the frame or a slight malpositioning of the rod in the frame affects the measurement. We have also found the trial frame limits the extent of excursion of the eyes from primary to other gaze positions and thereby limits the usefulness of the method in cases of mild paresis of a cyclovertical muscle. Moreover, in this method the extent of excursion of the eyes from the primary positions cannot be measured, and therefore identical testing condition cannot be provided in subsequent followups, which is essential for comparing the findings in order to assess progress.The after-image method as described by Sood and Sen (1970) is useful, but some patients find it difficult to appreciate the tilt of the after-image, especially when it is slight. This method is also less convenient for measuring the deviation in the 9 cardinal positions of gaze, as the after-image often does not last long enough and has to be produced several times. Since a major amblyoscope is used in most orthoptic centres to measure horizontal and vertical deviation, it is quite convenient to measure