Non-tensile tunica albuginea plication for the correction of penile curvature
Objective To evaluate the efficacy of non-tensile tunica albuginea plication (NTTAP) using nonabsorbable sutures for the correction
of congenital and acquired penile curvature and to determine the key points for a successful outcome of this procedure.
Patients and Methods From June 2004 to July 2007, 43 patients with penile curvature (35 congenital and 8 secondary to Peyronie’s disease) underwent
surgical correction by NTTAP. The indications were difficult or impossible vaginal penetration, and a cosmetically unacceptable
penis. For tunica albuginea plication (TAP) we applied the 16 dot procedure using non-absorbable sutures (Tycron® 2/0 polyester
Results After a mean follow-up period of 18 months, successful results with respect to penile straightening, normal erection, penetration
and sensation, confirmed both subjectively and objectively, were achieved in all patients. Post-operative penile shortening
of less than 1.5 cm was present in 50% of the cases, but did not affect intercourse. Post-operative complications were mild
and reversible; they consisted of penile skin necrosis after circumcising incisions and post-operative pain upon nocturnal
erection that subsided after a few weeks with the frequent use of ice compresses. The overall satisfaction rate was nearly
100% (35/43 very satisfied and 8/43 satisfied).
Conclusion NTTAP is a simple and effective method for the correction of congenital and acquired penile curvature. The key points for
successful outcomes are: clear identification of the line of maximum curvature, adequate pre-operative evaluation, counseling
of the patient to set appropriate expectations, and careful discussion of the location of the suture sites. There is no need
for mobilization of the urethra or neurovascular bundle, which adds a great advantage to this easy and simple technique. Cutting
through the tunica albuginea, which may prevent postoperative erectile dysfunction, is not necessary. A disadvantage of this
procedure is that it cannot correct hour-glass deformity.