Shaeer's Corporal Rotation III: Shortening-Free Correction of Congenital Penile Curvature—The Noncorporotomy Technique

Abstract

BackgroundShortening-free correction of congenital ventral penile curvature by rotation of the corpora cavernosa was first introduced in 2006 (Shaeer's corporal rotation I). The basic principle was shifting the concavity of both corpora cavernosa from the ventral aspect of the penis to the lateral aspects, in opposition. Rotation was achieved by approximating short parallel incisions on the dorsum of both corpora cavernosa. In 2008, we reported modification of the technique (Shaeer's corporal rotation II), in which the incisions spanned the whole length of the corpora cavernosa. ObjectiveThe current modification, Shaeer's corporal rotation III (the noncorporotomy technique) simplifies corporal rotation further and addresses shortcomings. Design, setting, and participantsThis is a retrospective study of 127 cases of congenital ventral penile curvature 25–90° operated at Kamal Shaeer Hospital, Cairo, Egypt, from 2009 to 2015. Surgical procedureThe neurovascular bundle was mobilized, and the corpora were rotated by approximating premarked respective points on either side of the deep dorsal vein using polyester sutures without incising the tunica albuginea. Outcome measurements and statistical analysisIntraoperative postrotation angle and erect length and girth. Results and limitationsOn-table measurements showed a mean prerotation erection angle of 66.5°±17.9° (range: 25–90°; median 65°). Following rotation, the angle was 0.47°±1.8° (p<0.001) and length was 0.06±0.25cm longer (p=0.007), whereas girth was 0.77±0.9cm narrower (p<0.001). Complications included 11 cases (8.7%) of ventral wound gaping and 3 (2.4%) with mild recurrence not requiring correction. The International Index of Erectile Function was 24.99±0.9, with an increase of 13.35±3.4 over the preoperative state (p<0.001). ConclusionsShaeer's corporal rotation III enables correction of any degree of ventral congenital penile curvature, with neither shortening nor erectile dysfunction. Patient summaryShaeer's corporal rotation is a surgical technique for correction of severe degrees of innate downward curvature of the penis, without shortening.