Zandoná, P.,  Barros, G.,  Coimbra, I.,  Góes, P., Pato, E., Nahas, W., Hallak, J.,  Nascimento, B.

Congenital Penile Curvature, Peyronie’s Disease, Plication Technique

Either Congenital Penile Curvature or Peyronie’s Disease may cause ventral curvatures. Depending on severity, it may lead to functional limitation during sexual activity and require correction. 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 and its complications [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 description, results and long-term follow-up of the Giammusso corporoplasty in adults [6].  We aimed to demonstrate with this video article the step by step of this previously published technique for ventral penile curvature correction. This video is a compilation of images of three surgeries performed for ventral penile curvature utilizing an adaptation of the Giammusso Corporoplasty technique. 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. The three patients shown in this video obtained functional penile alignment, and no change in glans sensation. No severe adverse event was observed. This video article describes Deep Dorsal Vein Bed Plication, a feasible and effective technique for ventral penile curvature treatment, either congenital or acquired, which avoids neurovascular bundle dissection and its associated risks such as glans hypoesthesia and glans necrosis.

1- Carson CC, Levine LA. Outcomes of surgical treatment of Peyronie's disease. BJU Int. 2014 May;113(5):704-13.

2- Van Der Horst C, Portillo FJM, Seif C, Alken P, Juenemann KP. Treatment of penile curvature with Essed‐Schröder tunical plication: aspects of quality of life from the patients’ perspective. BJU international 93.1 (2004): 105-108.

3- Yosef YB, Binyamini J, Matzkin H, Ben-Chaim J. Midline dorsal plication technique for penile curvature repair. The Journal of Urology 172.4 (2004): 1368-1369.

4- Soygur T, Filiz E, Zumrutbas AE, Arikan N. Results of dorsal midline plication in children with penile curvature and hypospadias. Urology, 65.4 (2004): 795-798.

5- Akdemir F, Kayıgil Ö, Okulu E. Dorsal Plication Technique for the Treatment of Congenital Ventral Penile Curvature: Long-Term Outcomes of 72 Cases. J Sex Med. 2021 Oct;18(10):1715-1720.

6- Bagnara V, Arena S, Castagnetti M, Esposito C, Di Fabrizio D, Romeo C, Giammusso B. Giammusso corporoplasty for the treatment of isolated congenital ventral penile curvature: Results and long-term follow-up. Andrologia. 2021;53:e13934.