Penile Curvature – Shortening

Shortening Techniques for Correction of Penile Curvature

The principle is: since the curved penis has a longer surface (convex) and a shorter surface (concave), the surgeon may shorten the longer convex surface to match the shorter concave surface.

penile-curvature-shortening L

Advantages:

Shortening techniques are the simplest and easiest of the surgical options for correction of penile deviation.

Disadvantages:

Shortening

Indications:

Since there is shortening involved, this technique is most-suited for mild to moderate degrees of penile curvature, in order to limit the loss in length, since it is proportionate to the degree of curvature. In the vast majority of cases operated upon by shortening techniques, the penis though shorter, will still be in the normal range for satisfactory coital activity.

Success Rate and Complications:

The success rate of shortening techniques for correction of penile curvature is very high, >95%.  Some degree of shortening occurs, and there is sometimes a decrease in sensitivity of the penis, which is partial, and is reversible in most patients within a couple of months. Recurrence is possible in 10% of cases, but is usually a mild recurrence that does not require further surgery.

Surgery is a one-day procedure that does not require hospital stay except for  few hours. The patient is freely mobile the same day. However, it is advised to refrain from sexual activity for a minimum of 3 months.

Surgical Technique

Classically, an incision is performed under the glans penis, and skin is pulled back to expose the point of maximum curvature in the state of full erection. A permanent suture is used to shorten the convex side at the point of maximum curvature. Needle entry points are depicted in this illustration: a-e, and are passed through the walls of the erection cylinders (tunica albuginea (walls) of the corpora cavernosa (cylinders). Never min that!). Tying this suture line approximates all points and achieves shortening of the convex side, thereby straightening the penis. This is repeated as needed until full correction is achieved. This is called the "16-dot Technique"

The 16-Dot Technique has the virtue of simplicity and that the erection cylinders need not be opened up. Older techniques such as the modified Nesbit technique involve opening up two small incisions in the wall of the erection cylinders and suturing them together. Such techniques are still very valid alternatives.

Professor Shaeer, the Andrology Expert, has developed a new variant of shortening techniques that decreases the possibility of recurrence:

Shaeer's Double-Eight Plication

With the classical plication technique, all the suture entry/exit points are aligned on one longitudinal plane. With subsequent erections, this suture line may tear through, leading to recurrence of curvature (10%). The “Double-Eight Plication Technique” (Double-8 technique) described herein avoids the fore mentioned by distributing the needle entry-exit points on several planes, thereby decreasing the possibility of recurrence (5%).

Shaeer's Double Eight Plication technique is published at the Journal of Genital Surgery (Click the image)