EVALUATING THE SURGICAL OUTCOMES OF CONGENITAL PENILE CURVATURE TREATMENT WITH SHAEER III TECHNIQUE

Abstract

When sexually aroused, the blood vessels in the penis relax and open up to allow blood to fill the venous sinuses of the corpora cavernosa. The blood trapped under high pressure creates an erection to enable sexual intercourse. However, the penis is not always straight when erected. Some degrees of curving are present in a normal penis and do not interfere with coitus. When the degree of curvature exceeds 30 degrees, sexual satisfaction is affected.1 There are two forms of penile curvature which are congenital penile curvature (CPC or chordee) and Peyronie’s disease. CPC is a relatively uncommon condition with a prevalence of less than 1 percent in males.2 CPC is considered to be a result of the abnormal development of the tunica albuginea of the corpora cavernosa and not usually associated with urethral malformations.3,4 In most cases, the curvature is observed in the ventral size but it can occur laterally, dorsal curvature is quite rare. CPC may be present when the patients reach puberty and become more apparent with erection. Severe curvature may interfere with sexual intercourse and the patients have to seek medical treatment. In cases of CPC, medical and sexual history taking is sufficient to establish a diagnosis. Physical examinations are useful in measuring the degree of curvature and to eliminate other possible conditions including Peyronie’s disease. The gold standard treatment for CPC is surgical correction. Many techniques for curvature correction have been developed and improved. Nesbit is one of the pioneer surgeon who described a technique that shortens the convex side of the penile shaft in 1965.5 Since then, many modifications of this technique have been proposed to improve the success rate and reduce complications.6–8 However, the majority of these procedures had a similar disadvantage of shortening the length of the penis for 1-2.5 cm.9–11 More recently, grafting technique has also been proposed to treat CPC. However, the effectiveness of the grafting technique was too limited to recommend as a standard treatment. In 2006, Shaeer et al. proposed a technique based on the principle of corporal rotation at the maximum point of curvature. The opposition of the concavity, therefore, diminished the curving effect.12 The advantage of this technique is the preservation of the penile length while effectively correcting the curvature. However, this is a novel technique and has not been applied generally. Therefore, we conducted the thesis:” Evaluating the surgical outcomes of congenital penile curvature treatment with Shaeer III technique” with the following aims: 1. Describe the clinical characteristics of congenital penile curvature patients 2. Evaluate the short-term outcomes of congenital penile curvature treatment with Shaeer III technique