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The correction of congenital penile curvature in young men
1Department of Urology, University of California, San Francisco, USA.
Insights
Multiple parallel plication (MPP) effectively corrects congenital penile curvature in young men, with 80% achieving a straighter penis and satisfactory intercourse. This surgical technique offers advantages like avoiding neurovascular complications and can be done under local anesthesia.
Area of Science:
- Urology
- Andrology
- Surgical Techniques
Background:
- Congenital penile curvature requires surgical correction, particularly in young men experiencing stronger erections.
- Traditional techniques may risk neurovascular or urethral injury.
Purpose of the Study:
- To evaluate the long-term outcomes of the multiple parallel plication (MPP) technique for congenital penile curvature in young males.
- To assess the efficacy and safety of MPP considering the higher erection pressures in this demographic.
Main Methods:
- A retrospective review of young men who underwent MPP for congenital penile curvature between 1992 and 1995.
- Data collection included chart review and telephone surveys for long-term follow-up.
Main Results:
- Ten patients (mean age 22.3 years) were followed for a mean of 2.8 years.
- Eighty percent (8/10) achieved successful outcomes, with a straighter penis and/or satisfactory intercourse.
- Minor complications included palpable sutures and one case of recurrent curvature.
Conclusions:
- Multiple parallel plication (MPP) is a safe and effective surgical option for congenital penile curvature in young men.
- The technique avoids dissection of critical structures, minimizing risks of impotence and urethral injury.
- Potential drawbacks include palpable sutures and a risk of priapism, requiring patient counseling.
Objective:
To determine the long-term outcome of multiple parallel plication (MPP) used for correcting congenital penile curvature (with normal urethra and corpus spongiosum), a technique which takes account of the greater force of erection in young men (mean arterial pressure approximately 100 mmHg) than in neonates (approximately 60 mmHg).
Patients And Methods:
All young men who underwent surgical correction of congenital penile curvature using the multiple parallel plication technique between 1992 and 1995 were reviewed, from their charts and by a telephone survey.
Results:
Ten patients (mean age 22.3 years, SD 4, range 17-29) were identified, all of whom had been followed for more than one year (mean 2.8, SD 1.3, range 1.2-4.8). All 10 patients reported a preoperative curvature of 60-90 degrees; postoperatively, eight of the 10 patients had a successful outcome, based on self-documentation of a straighter penis (eight) and/or satisfactory intercourse (four). Two of these eight requested follow-up plications to correct a residual curvature of 15 degrees. All patients reported feeling the sutures as a small bump on the dorsal aspect of the penis. In one patient this was considered bothersome, but it did not interfere with intercourse. In one patient the curvature recurred 5 weeks after surgery, following intercourse. Another patient was lost to follow-up and could not be evaluated.
Conclusion:
The MPP technique has the following advantages; it entails no dissection of the neurovascular bundle or corpus spongiosum of the tunica, avoiding complications (such as impotence and urethral injury) that may occur with manipulation of these structures; it can be performed under local anaesthesia and can be completed within 30 min; suture cut-through is unlikely because the dorsum (12 o'clock position) of the tunica albuginea is the thickest and hence strongest area of the corporal body; and the straightness of the penis can be determined easily because erection is sustained throughout the procedure. The disadvantages of the MPP technique are; several small bumps from the nonabsorbable sutures may be palpable, and the patient needs to be informed of this preoperatively: aspiration and phenylephrine injection may be required to prevent priapism.