Modified Superficial Tunica Albuginea Excision Corporoplasty for Congenital Penile Curvature (CPC)

L. Karapanos

Congenital penile curvature, Corporoplasty, Tunica albuginea, Penile straightening, Absorbable sutures

Congenital penile curvature (CPC) is commonly corrected with Nesbit-type excision or plication techniques, which may expose the cavernosal tissue or rely on permanent suture material. This video demonstrates a modified superficial tunica albuginea excision corporoplasty that combines the stratified tunical concept described by Perdzyński and Adamek with the geometric principles of superficial tunica albuginea excision. We present a 19-year-old patient with symptomatic 90° ventral CPC. The video shows penile degloving and mobilization of the neurovascular bundle, followed by artificial erection to identify the points of maximal curvature. The superficial longitudinal layer of the tunica albuginea is then selectively excised while the internal transverse layer is preserved. The resulting defects are closed transversely with absorbable running sutures, and repeated intraoperative artificial erection testing confirms complete straightening. Corporal integrity is maintained throughout, the cavernosal bodies are not opened, and bleeding is minimal. Operative time was 93 minutes. Using absorbable sutures avoids the palpable knots and discomfort associated with permanent plication material. The final result shows a straight penis with good symmetry and a satisfactory shaft contour. At 1-year follow-up, there was no residual curvature and erectile function was fully preserved (Erection Hardness Score 4/4, IIEF-5-Score 25/25). Stretched penile length was 16 cm compared with 17 cm preoperatively, a modest 1 cm loss considering the 90° correction. Modified superficial tunica albuginea excision corporoplasty is an anatomically respectful and less invasive option for CPC correction, even for severe curvature. Preserving the internal tunical layer, avoiding cavernosal violation and correcting the curvature in geometric steps provided straightening that was maintained at 1 year, with preserved erectile function. The technique may also reduce the risk of sensory impairment, long-term suture-related discomfort and recurrence, although larger series with longer follow-up are needed to confirm these advantages.

None.

Consultant for Boston Scientific, Coloplast, Medtronic

1. Perdzyński W, Adamek M. A new corporoplasty based on stratified structure of tunica albuginea for the treatment of congenital penile curvature – long-term results. Cent European J Urol. 2015;68(1):102–108.
2. Kuehhas FE, Egydio PH. Superficial tunica albuginea excision, using geometric principles, for the correction of congenital penile curvature. BJU Int. 2012;110:E949–E953.