ONE STAGE CORRECTION OF CONGENITAL COMPLEX PENILE CURVATURE BY COMBINED MODIFIED NESBIT'S PROCEDURE WITH DORSAL DARTOS FLAP

Abstract

Background: Congenital complex penile curvature (CCPC) is a rare deformity that arises from asymmetry of the corpora cavernosa. Congenital complex penile curvature has two abnormality components: torsion and curvature of the penis either ventral or dorsal. Objectives: Evaluation of one stage correction of CCPC by combination of modified Nesbit's procedure with dorsal dartos flap. Patients and Methods: This prospective study was conducted at Al-Azhar University Hospital in Damietta. Twenty eight patients with CCPC were evaluated and corrected during the period from October 2014 to September 2017. Their mean age was 5.5±2.1years (range 2–9.5 y). The direction of mal-rotation was anticlockwise in 23 patients and clockwise in 5 patients. Fifteen cases have ventral curvature; 8cases have dorsal curvature, while 5 cases have lateral curvature. All cases were treated firstly by modified Nesbit's procedure for correction of chordee, and then dorsal dartos flap was used for correction of penile mal-rotation in one stage. Results: All patients were corrected with high success rate. There were no more than 10° of residual mal-rotation or binding in all patients. One patient (3.57%) had penile hematoma that treated conservatively. All patients and their parents were satisfied with wonderful cosmetic and functional outcomes with no recurrent mal-rotation or binding. All cases were followed up for a mean follow up period of 9 ± 1.7 months (range 6 - 12 m.). Conclusion: Congenital complex penile curvature can be treated in one-stage surgery with excellent cosmetic and functional outcomes by combination of modified Nesbit's procedure with dorsal dartos flap.