Dorsal tunica albuginea plication to correct congenital and acquired penile curvature: a long‐term follow‐up

Abstract

Authors from Jerusalem evaluated the long‐term efficacy of a tunica albuginea dorsal plication technique in the treatment of congenital and acquired curvature of the penis. They assessed their experience in 83 patients aged 1‐8 years who underwent this procedure over a 10‐year period. They found it to be a simple technique with considerable long‐term efficacy. OBJECTIVE To evaluate the long‐term efficacy of a tunica albuginea dorsal plication technique for treating congenital and acquired penile curvature. PATIENTS AND METHODS We retrospectively evaluated 83 patients (median age 1.8 years) who had their penile curvature corrected surgically using dorsal tunica albuginea plication between 1992 and 2002. The results were evaluated objectively using a pharmacological erection test or subsequently based either on the parents’ reports or patients’ self‐assessment. The median (range) follow‐up was 6 (0.7–10) years. RESULTS Seventy (84%) patients had penile plication as an integral part of hypospadias repair, while the remaining 13 (16%) with a normal urethra had dorsal plication only. Twenty‐eight (34%) of the 83 patients had an erection test during a repeat hypospadias repair or closure of a urethrocutaneous fistula; 22 of these had a straight penis, while the remaining six required additional plication for a satisfactory cosmetic outcome. Parents of 45 (54%) children reported that their child had a normal erection with no chordee during the follow‐up. Ten (12%) adult patients reported straight erections enabling satisfactory penetration and sensation during sexual intercourse. None of the patients reported penile shortening or erectile dysfunction after surgery, and none had recurrent curvature during the follow‐up. There was no difference in the results between patients with congenital or acquired penile curvature. CONCLUSIONS Dorsal plication of the tunica albuginea is a simple and effective method in the long term for correcting congenital and acquired penile curvature.

Long-term patient satisfaction after surgical correction of penile curvature via tunical plication

“…Actually, our results are in contradiction with already published material, using absorbable sutures where younger patients (< 24 yr) had a higher chance of suture failure than elder patients (14). Long-term results of plication techniques in the pediatric setting are rarely reported, but success seems to be the rule (8,9,15,16). In our experience, the long-term degree of subjective satisfaction among patients with CPC was remarkable and supports the philosophy of corporoplasty in this setting.…”

“…In previous studies, satisfaction results were almost identical in both settings (16,20). In our experience, the differences affected all aspects including those related to the curvature correction, perhaps reflecting a better performance of plication techniques in the management of totally stable deformity, as in congenital curvatures; in other words, it might be that patients with PD presumed stable were still in progression.…”

Outcome of hypospadias repair in toilet-trained children and adolescents

“…As we have previously reported the formal Nesbit operation was performed in 4 and dorsal plication which was adopted since 1992 was required in the remaining 10 patients [10]. Corporoplasty fixed chordee in all but one patient who required additional dorsal plication and release of skin chordee 12 years following primary repair.…”

Congenital genitourinary anomalies and sexual function

“…Theiss et al 11 showed that intercourse was possible in all study subjects following the correction. In a report by Chertin et al, 12 none of the 83 patients reported penile shortening or erectile dysfunction following surgery and there was no recurrence reported during median follow-up of 6 years. Following repair in another report, all patients showed elimination of penile curvature with preserved erectile function in 92% and an 83% full satisfaction rate.…”