Penoscrotal plication as a uniform approach to reconstruction of penile curvature

Objective To present our 4-year experience of using a minimally invasive technique, penoscrotal plication (PSP), as a uniform treatment for men with debilitating penile curvature resulting from Peyronie's disease. Patients and Methods In 48 men (median age 58.7 years) with penile curvature the penis was reconstructed by imbricating the tunica albuginea opposite the curvature with multiple nonabsorbable sutures. All patients, regardless of the degree or direction of curvature, were approached through a small penoscrotal incision made without degloving the penis. Detailed measurements of penile shaft angle and stretched penile length were recorded and analysed before and after reconstruction, and the numbers of sutures required for correction were documented. Results Nearly all patients had dorsal and/or lateral deformities that were easily corrected via a ventral penoscrotal incision. The median (range) degree of correction was 28 (18-55)° and number of sutures used was 6 (4-17). Stretched penile length measurements before and after plication showed no significant difference. A single PSP procedure was successful in 45/48 (93%) patients; two were dissatisfied with the correction, one having repeat plication and the other a penile prosthesis; one other required a suture release for pain. Conclusions PSP is safe and effective and should be considered even for cases with severe or biplanar curvature.