Dorso-lateral penile curvature correction

Abstract

IntroductionDorsal penile curvature was first described in 1980 by Don A. Udall. [1] There is a limited number of articles dedicated to dorsal and lateral penile curvature correction in patients with/without hypospadias. [1–5]. In the presented video, our objective was to demonstrate a technique of dorso-lateral curvature correction. Material and methodsA 5-year-old boy presented with a congenital dorso-lateral penile curvature. With a circumferential incision along the coronal edge full degloving is performed. An artificial erection test showed dorsal and right-sided lateral curvature. Firstly, the lateral curvature is corrected. Buck's fascia is opened on the contralateral (left) side – above the left cavernous body. An incision is made and plicating sutures are placed. Another artificial erection test is performed, which showed corrected lateral (right-sided) curvature and present dorsal curvature. To correct dorsal curvature Buck's fascia is opened on the ventral side, incisions are made on both sides at the same paraurethral level, and plicating sutures are placed. Final artificial erection test demonstrated a straight penis. Integrity of Buck's fascia is restored. Excessive skin is removed, and penile skin is reconstructed along the coronal edge. At the end of the surgery, natural circumcised penile appearance is achieved. The results of the surgery were analyzed in both early- and long-term follow-up of up to 2 years. ResultsIn early and 2-year follow-up, the patient had successful results of the treatment – cosmetic result was close to nature, no scarring and edema were present. No recurrent penile curvature was recorded. ConclusionsThe developed method of dorso-lateral penile curvature correction allows to get successful both cosmetic and functional results, and decrease the number of postoperative complications and recurrence of curvature.