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Non-tensile tunica albuginea plication for the correction of penile curvature

Abstract

Objective

To evaluate the efficacy of non-tensile tunica albuginea plication (NTTAP) using nonabsorbable sutures for the correction of congenital and acquired penile curvature and to determine the key points for a successful outcome of this procedure.

Patients and Methods

From June 2004 to July 2007, 43 patients with penile curvature (35 congenital and 8 secondary to Peyronie’s disease) underwent surgical correction by NTTAP. The indications were difficult or impossible vaginal penetration, and a cosmetically unacceptable penis. For tunica albuginea plication (TAP) we applied the 16 dot procedure using non-absorbable sutures (Tycron® 2/0 polyester fiber).

Results

After a mean follow-up period of 18 months, successful results with respect to penile straightening, normal erection, penetration and sensation, confirmed both subjectively and objectively, were achieved in all patients. Post-operative penile shortening of less than 1.5 cm was present in 50% of the cases, but did not affect intercourse. Post-operative complications were mild and reversible; they consisted of penile skin necrosis after circumcising incisions and post-operative pain upon nocturnal erection that subsided after a few weeks with the frequent use of ice compresses. The overall satisfaction rate was nearly 100% (35/43 very satisfied and 8/43 satisfied).

Conclusion

NTTAP is a simple and effective method for the correction of congenital and acquired penile curvature. The key points for successful outcomes are: clear identification of the line of maximum curvature, adequate pre-operative evaluation, counseling of the patient to set appropriate expectations, and careful discussion of the location of the suture sites. There is no need for mobilization of the urethra or neurovascular bundle, which adds a great advantage to this easy and simple technique. Cutting through the tunica albuginea, which may prevent postoperative erectile dysfunction, is not necessary. A disadvantage of this procedure is that it cannot correct hour-glass deformity.

References

  1. Cormio L, Zizzi V, Bettocchi C, Berardi B, Sblendorio D, Traficante A, et al. Tunica albuginea plication for the correction of penile curvature. Scand.J.Urol.Nephrol. 2002;36(4):307–310.

    Article  PubMed  CAS  Google Scholar 

  2. Yachia D, Beyar M, Aridogan IA, Dascalu S. The incidence of congenital penile curvature. J.Urol. 1993; Nov;150(5 Pt 1):1478–1479.

    PubMed  CAS  Google Scholar 

  3. Carson CC. Francois Gigot de la Peyronie (1678–1747). Invest.Urol. 1981; Jul;19(1):62–63.

    PubMed  CAS  Google Scholar 

  4. Dean RC, Lue TF. Peyronie’s disease: Advancements in recent surgical techniques. Curr.Opin.Urol. 2004; Nov;14(6):339–343.

    Article  PubMed  Google Scholar 

  5. Nesbit RM. Congenital curvature of the Phallus: Report of three cases with description of corrective operation. J.Urol. 1965; Feb;93:230–232.

    PubMed  CAS  Google Scholar 

  6. Essed E, Schroeder FH. New surgical treatment for Peyronie’s disease. Urology. 1985; Jun;25(6):582–587.

    Article  PubMed  CAS  Google Scholar 

  7. Ebbehoj J, Metz P. New operation for «Krummerik» (Penile curvature). Urology. 1985; Jul;26(1):76–78.

    Article  PubMed  CAS  Google Scholar 

  8. Baskin LS, Lue TF. The correction of congenital penile curvature in young men. Br.J.Urol. 1998; Jun;81(6):895–899.

    PubMed  CAS  Google Scholar 

  9. Gholami SS, Lue TF. Correction of penile curvature using the 16-dot plication technique: A review of 172 patients. J.Urol. 2002; May;167(5):2066–2069.

    Article  PubMed  Google Scholar 

  10. Helal MA, Lockhart JL, Sanford E, Persky L. Tunica vaginalis flap for the management of disabling Peyronie’s disease: Surgical technique, results and complications. Urology. 1995; Sep;46(3):390–392.

    Article  PubMed  CAS  Google Scholar 

  11. Andrews HO, Al Akraa M, Pryor JP, Ralph DJ. The Nesbit operation for Peyronie’s disease: An analysis of the failures. BJU Int. 2001; May;87(7):658–660.

    Article  PubMed  CAS  Google Scholar 

  12. Hassan AA, Salem K, El Gamal S, Sabae M. Long-term results of tunical plication in treatment of Peyronie’s disease. Egypt.J.Urol. 2005;12:194–199.

    Google Scholar 

  13. Chien GW, Aboseif SR. Corporeal plication for the treatment of congenital penile curvature. J.Urol. 2003; Feb;169(2):599–602.

    Article  PubMed  Google Scholar 

  14. Thiounn N, Missirliu A, Zerbib M, Larrouy M, Dje K, Flam T, et al. Corporeal plication for surgical correction of penile curvature. Experience with 60 patients. Eur. Urol. 1998;33(4):401–404.

    Article  PubMed  CAS  Google Scholar 

  15. Ghanem H, Shamloul RM. Incisional corporoplasty for the correction of congenital penile curvature: A review of two suturing techniques. Int.J.Impot.Res. 2008; Mar–Apr;20(2):222–225.

    Article  PubMed  CAS  Google Scholar 

  16. Hsieh JT, Liu SP, Chen Y, Chang HC, Yu HJ, Chen CH. Correction of congenital penile curvature using modified tunical plication with absorbable sutures: The longterm outcome and patient satisfaction. Eur.Urol. 2007; Jul;52(1):261–266.

    Article  PubMed  Google Scholar 

  17. Lee SS, Meng E, Chuang FP, Yen CY, Chang SY, Yu DS, et al. Congenital penile curvature: Long-term results of operative treatment using the plication procedure. Asian J.Androl. 2004; Sep;6(3):273–276.

    PubMed  Google Scholar 

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Correspondence to Hazem R. Ismail.

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Ismail, H.R., Youssef, M., Sakr, M. et al. Non-tensile tunica albuginea plication for the correction of penile curvature. Afr J Urol 15, 88–95 (2009). https://doi.org/10.1007/s12301-009-0019-2

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  • DOI: https://doi.org/10.1007/s12301-009-0019-2

Keywords

  • Plication procedure
  • Peyronie’s disease
  • penile curvature