Penile plication without degloving enables effective correction of complex Peyronie's deformities

To present our initial experience with extended plication repair for men with severe and/or biplanar penile curvature.

A review of men who underwent plication repair for complex penile deformity (biplanar curvature or curvature ≥ 60°) was performed. All patients underwent tunical plication via a 2-cm penoscrotal incision mobilized distally along the penile shaft without degloving. Angle of curvature, direction(s), stretched penile length (SPL), and number of sutures were recorded.

Among 102 patients treated with plication surgery, 43 (44%) had complex penile deformity. Among 11 men with biplanar curvature, median angle in the primary plane of curvature was corrected from 45° to 10° and secondary plane was corrected from 35° to 5° using an average of 7 sutures (5° correction per suture). Among 32 men with severe curvature, median angle of curvature was corrected from 70° to 15° using an average of 11 sutures (6° correction per suture). SPL was unchanged in 29 (69%), increased an average of 0.65 cm in 7 (16%), and decreased 0.5 cm in only 6 (14%) patients. At a mean follow-up of 15.3 months, repeat plication was required in 2 patients and 2 required penile prosthesis.

Penile plication without degloving appears to be safe and effective for correction of complex penile curvature without significant impact on penile length.