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Inicio Actas Urológicas Españolas (English Edition) Rotation of the corpora cavernosa for the treatment of congenital penile curvatu...
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Vol. 39. Issue 5.
Pages 332-335 (June 2015)
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Vol. 39. Issue 5.
Pages 332-335 (June 2015)
Skill and talent
Rotation of the corpora cavernosa for the treatment of congenital penile curvature
Rotación de los cuerpos cavernosos para el tratamiento de la incurvación peneana congénita
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R. Molina-Escudero
Corresponding author
robersescu@hotmail.com

Corresponding author.
, L. Crespo-Martínez, M. Dorado-Valentín, L. Rodríguez-Sánchez, Á. Páez-Borda
Servicio de Urología, Hospital Universitario de Fuenlabrada, Madrid, Spain
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Table 1. Pre and postoperative clinical characteristics of patients.
Abstract
Introduction

Congenital penile curvature (CPC) is caused by a disorder in the embryonic development of the urethra and corpora cavernosa. The condition causes difficulty for penetration, requiring surgical correction when it prevents intercourse.

Material and methods

We present the cases of 2 men in their 40s who had ventral curvature greater than 60° of 2 years of evolution, with maintained erections. The patients underwent surgery for rotation of the corpora cavernosa. After the complete denudation of the penis, athermal release of the neurovascular bundle of the penis from the ventral side to the dorsal was performed. Once the curvature was verified using artificial erection, an incision was performed in the tunica albuginea of both corpora cavernosa, continuously suturing both internal and external margins with resorbable monofilament. The rectification of the curvature was then checked, and the mucocutaneous plane was reconstructed.

Results

The surgical time was 120min and there were no intraoperative complications. Both patients were discharged 24h after the surgery. At 1 week, the patients experienced spontaneous night-time erections and were able to maintain sexual relations 1 month after the surgery. At 6 months, the residual curvature was less than 20°, the penile shortening was less than 1cm and the International Index of Erectile Function-5 was 25 for both cases.

Conclusions

Surgery for rotation of the corpora cavernosa helps correct CPC without significant penile shortening or erectile dysfunction. In our opinion, the procedure is an appropriate treatment for patients with CPC but requires studies with long-term follow-up in order to consider it the technique of choice.

Keywords:
Congenital penile curvature
Rotation of corpora cavernosa
Tunica albuginea plication
Resumen
Introducción

La incurvación peneana congénita (IPC) está originada por una alteración en el desarrollo embrionario de la uretra y los cuerpos cavernosos. Condiciona dificultad para la penetración, precisando corrección quirúrgica cuando imposibilita el coito.

Material y métodos

Presentamos 2 varones en la 4.ª década de la vida que presentan incurvación ventral superior a 60° de 2 años de evolución con erecciones mantenidas. Los pacientes fueron sometidos a cirugía de rotación de los cuerpos cavernosos. Tras la denudación completa del pene se realiza la liberación atérmica del paquete vasculonorvioso del pene desde la cara ventral hasta la dorsal. Una vez evidenciada la incurvación mediante una erección artificial se realiza una incisión en la albugínea de ambos cuerpos cavernosos, suturando de forma continua con monofilamento reabsorbible ambos bordes internos y externos. Posteriormente se comprueba la rectificación de la incurvación y se reconstruye el plano mucocutáneo.

Resultados

El tiempo quirúrgico fue de 120min, no existiendo complicaciones intraoperatorias. Ambos pacientes fueron dados de alta a las 24h de la intervención. A la semana presentaban erecciones nocturnas espontáneas, pudiendo mantener relaciones sexuales al mes de la intervención. A los 6 meses la incurvación residual era inferior a 20°, el acortamiento peneano inferior al centímetro y el IIEF-5 de 25 en ambos casos.

Conclusiones

La cirugía de rotación de los cuerpos cavernosos permite corregir la IPC sin acortamiento peneano significativo ni disfunción eréctil. En nuestra opinión constituye un tratamiento adecuado en pacientes con IPC, necesitándose estudios con seguimientos a largo plazo para considerarla la técnica de elección.

Palabras clave:
Incurvación peneana congénita
Rotación de cuerpos cavernosos
Plicatura de albugínea

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