One-stage correction of congenital complex penile curvature by tunica albuginea plications

Congenital complex penile curvature has two deformity components: torsion and curvature of the penile shaft. Limited cases have been reported and were managed with an invasive Nesbit procedure. We introduce a novel simple surgical technique to correct the deformity in one stage.

Plications of the tunica albuginea were applied to treat five patients (median age, 28 yr) with congenital complex penile curvature. Mean follow-up duration was 14 months (range, 9-20 mo). In the first case, penile curvature was corrected first followed by the torsion. In the other four cases, the sequence was reversed. A parabolic curve was made from the subcoronal area crossing the dorsal midline and extending toward the penile base obliquely to the direction of counter-torsion. Along the curve, two points (one at the maximum convexity and the other depending on the type of curvature) were chosen for plications to correct torsion. The remaining curvature was corrected subsequently.

It took five plications to accomplish a satisfactory result in the first case. In the other four cases, only three plications were needed to correct the deformity. In all five patients, penile deformities were corrected successfully with either residual torsion or curvature being no more than 5 degrees. All patients were satisfied with excellent cosmetic and functional results with no recurrent curvature or torsion. All patients had started successful sexual intercourse shortly more than 2 months after the operation without erectile problems. One patient reported a mild sensory impairment of the penile skin that resolved 2 months later.

By correcting penile torsion and curvature in sequence with plications of the tunica albuginea, congenital complex penile curvature can be corrected in a one-stage operation with good cosmetic and functional results.