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Reconstructive surgery for recurrent penile curvature
Masahiro Takeda1, Shogo Seo2, Ryo Sueyoshi2
1Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan. mstakeda@juntendo.ac.jp.
Purpose:
There are surprisingly few reports about reconstructive surgery for severe recurrent/persistent penile curvature (redo-PC). We present our experience.
Methods:
We reviewed 9 redo-PC cases we treated between 1998 and 2016.
Results:
Cases 1-3 and 5 were identified from 111 consecutive hypospadias patients we treated between 1998 and 2016 (4/111; 3.6%). Cases 4 and 6-9 had initial surgery elsewhere. Initial PC was severe (> 45°; n = 5), moderate (30°-45°; n = 1), or unknown (n = 3), treated by dorsal plication (DP) in 4/9 (cases 1-4), chordectomy in 2/9 (cases 5, 6), and unknown in 3/9 (cases 7-9); no case had tunica albuginea incision (TAI). Straightening after initial surgery was confirmed by artificial erection (AE) in 4/9, not confirmed (2/9), and unknown (3/9). Cases 1, 2, 7 and 8 had had previous failed redos. Scarring of buccal mucosa used for urethroplasty caused worse PC in cases 7 and 9. After TAI (n = 6; cases 1, 3-6, and 8) or scar removal with DP (n = 3; cases 2, 7, and 9), AE confirmed successful straightening in all cases, without sequelae after a mean follow-up of 2.6 years.
Conclusion:
TAI was most effective for redo-PC surgery. Preoperative AE and examination under anesthesia should be used to customize treatment.
