An original mininvasive corporoplasty technique for penile curvature without circumcision

Objective: We describe an original minimallyinvasive penile plication technique with scro-tal or infrapubic access, not requiring circumcision, for penilecurvature of different severity and types. This technique can beused to correct both congenital and acquired curvatures, monoor bidirectional deformities.Materials and methods: Between 2012 and 2018 we treated 134patients suffering from congenital curvature (33) and acquiredcurvature from Peyronie's disease (101). The average curvaturewas 62.2° (± 30.4°). Preoperative evaluation includedprostaglandin E1 injection with photographic documentationand measurement of penile angulation, administration of IIEF-15, vasoactive penile Doppler ultrasound, analysis of thermaland vibratory sensitivity with Genito-Sensory-Analyzer (GSA)and assessment of nocturnal penile stiffness with Rigiscan, per-formed twice, for a detailed evaluation of patient’s erectile function.Scrotal access was performed in patients with dorsal and/or lat-eral penile curvature; the infrapubic access was performed inpatients with ventral curvature. After preparation and incisionof Colles’ fascia, penis was partially degloved and an originalplication technique called "binary corporoplasty" was performedat the site or sites established at preoperative assessment, withnon-resorbable synthetic multifilament (Premicron®) suture. Results: Complete correction of penile curvature was achieved in96.8 % of patients. No major complications were reported, andno patients suffered worsening in erectile function or in penilesensitivity. The average shortening of convex side was 1.65 cm(± 0.7 cm) and all patients report easy intercourse after correc-tion. The average time of surgery was 46 minutes (± 11 min)and all procedures were performed as a day-hospital or ambula-tory settings, with local anesthesia and light sedation. Overallsatisfaction rate is 96%.Conclusions: This is a simple and rapid technique that perfectlycorrects even the most severe and complex penile curvatures. Incomparison to traditional techniques, such as Nesbit procedure,this technique is associated with low morbidity, a very lowrecurrence rate and a great aesthetic results. Aesthetic andfunctional patients’ satisfaction was excellent.