Modified plication of the tunica albuginea in treating congenital penile curvature

Abstract

Objective To describe a modi®ed plication technique and compare the results with the Nesbit procedure for treating congenital penile curvature. Patients and methods Eleven men with congenital penile curvature were treated by a modi®ed tunica albuginea plication technique. An arti®cial erection was induced by normal saline injection; in the areas where plication was planned, Buck's fascia was opened longitudinally and dissected a short distance toward the midline to free the neurovascular bundles. Allis clamps were used to grasp the tunica albuginea and bumps' created. Two interrupted U-shaped sutures using 2/0 polyglactin were placed underneath each Allis clamp to secure the bump. The results were analysed retrospectively and compared with the results of 11 other men treated using the Nesbit procedure.Results The mean (range) follow-up was 25 (12±47) months for the Nesbit procedure and 15 (8±26) months for the modi®ed plication procedure. In the Nesbit group, eight patients had satisfactory cosmetic and functional results; three complained of penile shortening and one had erectile dysfunction. In the modi®ed plication group, 10 patients reported satisfactory cosmetic and functional results; one complained of penile shortening, two were concerned about the indurations of the penis but none had erectile dysfunction. Conclusions The modi®ed plication technique is easier to perform, is more often successful and causes fewer surgical complications than the Nesbit procedure for treating congenital penile curvature.

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

“…Some authors have raised concerns about the possibility of postoperative loss of glanular sensation (7,10,11). In our study, penile sensory changes were more prevalent in PD patients.…”

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

“…The success rate with dorsal plication of the tunica albuginea for correcting penile curvature is 85-100% [4][5][6][7][10][11][12][13] but some have raised concerns about the possibility of subsequent penile shortening or irregularity from the sutures, and pain during erection [11]. Temporary, and in one case total loss, of glanular sensation was reported [10].…”

“…Satisfactory results were also reported with this technique in patients with acquired penile curvature (Peyronie's disease) [8,13]. Most urologists acknowledge the success of dorsal tunica albuginea plication for correcting hypospadias curvature [5][6][7][8][9][10][11][12][13], but some have questioned the long-term implications of dorsal plication in childhood [5]. We reviewed our experience with tunica albuginea plication for correcting penile curvature, with special emphasis on the longterm results.…”

“…As penile curvature can be either congenital (associated or not with hypospadias) or acquired (mainly caused by Peyronie's disease) different surgical approaches could possibly be used. The aim of surgery for either congenital or acquired penile curvature is to straighten the penis but allowing a normal erection, enabling satisfactory penetration and sensation during sexual intercourse [2][3][4][5][6][7][8][9][10][11][12]. Since the introduction by Baskin and Duckett [5] of dorsal tunica albuginea plication for correcting hypospadias curvature with or without incisions, it has become the operation of choice in most patients.…”

A novel modification of tunical plication by plaque thinning: long-term results in treating penile curvature of Peyronie’s disease

“…Penile tunical plication is a minimal invasive shortening method that was also described by Nesbit and then modified and popularized as an alternative option for PD [22,[25][26][27][28]. The most prominent advantage of tunical plication is that the corpora cavernosa are not opened, which benefits such patients with better erectile capacity [20], furthermore, it is fast and simple to perform with less surgical complications [2,26].…”