V11-01 DEEP DORSAL VEIN BED PLICATION FOR VENTRAL PENILE CURVATURE

Abstract

You have accessJournal of UrologyCME1 Apr 2023V11-01 DEEP DORSAL VEIN BED PLICATION FOR VENTRAL PENILE CURVATURE Pedro Caetano Edler Zandoná, Guilherme Garcia Barros, Igor Valente Coimbra, Plinio Moreira De Góes, Eduardo Zinoni Silva Pato, William Carlos Nahas, Bruno Chiesa Gouveia Nascimento, and Jorge Hallak Pedro Caetano Edler ZandonáPedro Caetano Edler Zandoná More articles by this author , Guilherme Garcia BarrosGuilherme Garcia Barros More articles by this author , Igor Valente CoimbraIgor Valente Coimbra More articles by this author , Plinio Moreira De GóesPlinio Moreira De Góes More articles by this author , Eduardo Zinoni Silva PatoEduardo Zinoni Silva Pato More articles by this author , William Carlos NahasWilliam Carlos Nahas More articles by this author , Bruno Chiesa Gouveia NascimentoBruno Chiesa Gouveia Nascimento More articles by this author , and Jorge HallakJorge Hallak More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003337.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Either Congenital Penile Curvature or Peyronie’s Disease may cause severe ventral curvature. Historically, surgical techniques for this type of deformities were associated with longer operative time and greater patient dissatisfaction, mainly due to neurovascular bundle (NVB) dissection [1]. Previous studies described a midline dorsal plication technique in pediatric patients, allowing for an effective correction without requiring NVB manipulation [2-5]. Neuroanatomical studies have demonstrated the distribution of nerve fibers and identified the 12 o'clock position as the only nerve-free position [2]. Finally, in 2021, Bagnara et al published the description of the Giammusso corporoplasty in adults [6]. We aim to demonstrate with this video article the step by step of this previously published technique for ventral penile curvature correction. METHODS: This video article is a compilation of images of three surgeries performed for ventral penile curvature utilizing an adaptation of the Giammusso Corporoplasty technique. In the main video, the procedure was performed for a 26-year old male with a 62-degree ventral congenital penile curvature. Supplementary photographs of other two cases were added to the video: a 77-year old male with a 68-degree Peyronie’s ventral curvature and a 29-year old male with a 28-degree ventral congenital penile curvature. In all cases, a subcoronal incision was performed, and penile skin and Dartos’ fascia were degloved. The point of maximum curvature was identified after a saline induced artificial erection, Buck’s fascia was incised, and deep dorsal vein and its branches were then dissected and ligated. Differently from the Giammusso technique, we did not perform a corporoplasty, but a simple plication as described by Akdemir et al [5]. This latter technique however spares the deep dorsal vein. For the plication, after planning and marking their sites with Allys clamp and artificial erection confirming functional alignment, we utilized 3 inverted non-absorbable 2-0 coated polyester sutures for each plication site. Circumcision was performed for penile shaft closure. RESULTS: The three patients shown in this video obtained functional penile alignment, and no change in glans sensation. No severe adverse event was observed, with one patient developing a small penile hematoma managed conservatively. CONCLUSIONS: This video article describes Deep Dorsal Vein Bed Plication, a feasible and effective technique for ventral penile curvature treatment, which avoids NVB dissection and its associated risks such as glans hypoesthesia and glans necrosis. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e999 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Pedro Caetano Edler Zandoná More articles by this author Guilherme Garcia Barros More articles by this author Igor Valente Coimbra More articles by this author Plinio Moreira De Góes More articles by this author Eduardo Zinoni Silva Pato More articles by this author William Carlos Nahas More articles by this author Bruno Chiesa Gouveia Nascimento More articles by this author Jorge Hallak More articles by this author Expand All Advertisement PDF downloadLoading ...