• Penile Curvature Correction

Introduction

Penile Curvature Correction is the surgical repair of penile curvature which is caused by Peyronie’s disease or congenital curvature.

Lateral penile curvature is a quite frequent condition, affecting 4-10% of males. It is caused by an asymmetric embryonic development of the corpora cavernosa (congenital penile curvature), or by Peyronie´s Disease.

a-705x284

Peyronie’s (pay-roe-NEEZ) disease is the development of fibrous scar tissue inside the penis that causes curved, painful erections. Penises vary in shape and size, and having a curved erection isn’t necessarily a cause for concern. But Peyronie’s disease causes a significant bend or pain in some men.

This can prevent you from having sex or might make it difficult to get or maintain an erection (erectile dysfunction). For many men, Peyronie’s disease also causes stress and anxiety.

Peyronie’s disease sometimes goes away on its own. But in most cases, it will remain stable or worsen. Treatment might be needed if the curvature is severe enough that it prevents successful sexual intercourse.

Surgery usually isn’t recommended until you’ve had the condition for at least one year and the curvature of your penis stops increasing and stabilizes for at least six months.

Congenital penile curvature can only be treated surgically, using the same principles as in Peyronie’s disease, except surgery can be performed at any time in adults. Surgery is almost exclusively plication, resulting in high curvature correction rates of 67-97%.

CANDIDATES

Inclusion Criteria:

  • penile curvature more than 30 degree.

Exclusion Criteria:

  • Age: less than 18 years.
  • Non-orthotopic meatus
  • Patients with ED.

Operation Time:
The mean operative time of the procedure is 3 hours.

Type of Anesthesia use:
General Anesthesia or local anesthesia

Hospital/clinic stay:
Hospital Stay 1-2 days

Days to stay in Thailand:
At least 14 days.

Pre-Operation

Upon hospital admission, preoperative preparation includes blood tests, chest X-ray and ECG (electrocardiogram). In case you are on anticoagulant therapy, it may be required to interrupt your anticoagulant therapy a few days before the operation.

You should always consult your Cardiologist, for there may be need to replace anticoagulants with injections in the abdominal region.

The Procedure

The surgery requires general or spinal anesthesia. Initially, the patient is placed in the supine position and the area is sterilized. An incision is performed in the perimeter, beneath the glans (penile head), the penis is stripped from the skin and the curvature is corrected. In the majority of the patients the surgery is completed by circumcision. At the end of the procedure, tight bandaging is placed around the body of the penis, which bandaging is removed the following day. The average hospital stay is 2 days.

It is often required to place a catheter, which is usually removed the day after surgery.

In some cases, a graft obtained from an area of the patient’s body is used in order to repair the damage. More specifically, grafts may be taken from the skin dermis, oral mucosa, tunica fibrosa, tunica vaginalis, but may also be vascular grafts.

Post Operation

Patients were discharged after 16-24 hours. The first 24 hours you may feel pain in the area of surgery, which is controlled by analgesics. Upon discharge from hospital, you will also receive written instructions about:

  • the antibiotic treatment you will receive
  • For two weeks, you will need to abstain from any kind of physical exercise and strain, as well as evoked erections. Sometimes drugs are administered to prevent frequent erections.
  • Patients were instructed to avoid sexual activity during the first 6 weeks postoperatively.
  • They were evaluated in the outpatient clinic weekly for 8 weeks and annually thereafter.