Dorsal Plication Without Degloving Is Safe and Effective for Correcting Ventral Penile Deformities

• Published in: Urology (Ridgewood, N.J.) N.J.), 2014-11, Vol.84 (5), p.1228-1233
• Main Authors: Chung, Paul H, Tausch, Timothy J, Simhan, Jay, Scott, J. Francis, Morey, Allen F
• Format: Article
• Language: English
• Subjects: Adult; Aged; Biological and medical sciences; Humans; Male; Medical sciences; Middle Aged; Nephrology. Urinary tract diseases; Penile Induration - surgery; Penis - surgery; Perioperative Period; Postoperative Period; Retrospective Studies; Surveys and Questionnaires; Suture Techniques; Sutures; Treatment Outcome; Urologic Surgical Procedures - methods; Urology; Young Adult
• ISSN: 0090-4295; 1527-9995
• DOI: 10.1016/j.urology.2014.05.064

Objective To compare the safety and efficacy of patients undergoing dorsal penile plication with patients undergoing ventral and lateral plication. Methods A retrospective review was performed of all patients who underwent penile plication between 2007 and 2013. Plication was performed through a 2-cm longitudinal incision in the proximal or midpenile shaft without degloving. Plication sutures were placed in parallel opposite the angle of greatest curvature. Dorsal plication was performed with minimal displacement of the neurovascular bundle. Patient demographics, perioperative outcomes, and patient-reported outcomes were analyzed. Results Of 215 patients who underwent penile plication, complete operative and patient-reported outcomes data were available for 118 (55%). Patients were grouped by location of plication: dorsal (n = 17 [14%]), ventral (n = 65 [55%]), and lateral (n = 36 [31%]). Mean age (52-58 years; P  = .51) and preoperative curvature (36-51°; P  = .78) were similar among the 3 groups. Each group required a similar number of sutures (8-9; P  = .18) to achieve similar correction (37-45°; P  = .33). Patients completed a satisfaction survey at a mean of 15 months (range, 1-41 months) after surgery. All groups reported equally high rates of satisfaction for penile curvature ( P  = .64), penile rigidity ( P  = .64), strength of erection ( P  = .98), and overall satisfaction ( P  = .75). Although each group reported subjective decrease in penile length ( P  = .10), objective length loss occurred on a small scale (mean length loss for all groups, 0.3-0.8 cm; P  = .24). Conclusion Penile plication is a safe and effective technique for correcting all directions of curvature. Dorsal plication without degloving produces favorable objective and subjective results comparable to ventral and lateral plication.