Introduction and Objectives
Plication surgery is a simple technique, performed to correct penile curvature, either congenital or secondary to Peyronie's disease (PD). The long term results after traditional plication techniques have shown recurrence in about 25% of cases. The recurrence is probably due plication under a high tension and, subsequently, suture failure from tissue cut-through or suture breakage. To improve the outcome of surgical treatment for penile curvature, we decided to shift our surgery to a more standardized and minimal tension technique. Our objective is to report the outcomes of the 16-dotplication (16DP) for correction of penile curvature.
Material and Methods
12 patients (age 22–68 years) with penile curvature between 30° and 70° were selected for 16DP. Out of 12 cases, 3 patients were young (22–26 years), with congenital penile curvature. The other 9 patients (57–68 years) presented with curvature secondary to PD, mild erectile dysfunction and systemic vascular comorbidities. After a detailed inform consent regarding penile shortening, 16DP with Silk 2.0 was performed for all patients.
Results
The mean operative time was 64 minute (58 to 80). No immediate postoperative complications were recorded. Al patients returned to sexual activity 2 weeks after surgery, either spontaneous (10 patients) or after oral treatment (2 patients). The mean penile shortening was 0.7 cm (0.5 to 1.6). After a mean follow-up period of 10 months (3 to 20) 10 patients have complete straight penis and 2 have a mild deviation (under 5°).
Conclusions
In our experience 16DT is a short, simple and safe method to correct congenital and acquired penile curvature. Real time intraoperative straitening and parallel plication using a minimal tension are the main advantages of this technique. A good preoperative inform consent is essential to avoid dissatisfaction about penile shortening. Larger and longer patient series and comparative multicenter trials using this technique are mandatory in order to become a standard plication procedure for penile curvature.
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Copyright
© 2009 European Association of Urology. Published by Elsevier Inc. All rights reserved.
