Perovic plication and deep dorsal vein stripping results in congenital ventral penile curvature

Objective

Peyronie's disease , also known as induratio penis plastica or chronic inflammation of the tunica albuginea , is a connective tissue disorder involving the growth of fibrous plaques in the soft tissue of the penis affecting 5% of men. Specifically, scar tissue forms in the tunica albuginea, the thick sheath of tissue surrounding the corpora cavernosa causing pain, abnormal curvature, erectile dysfunction, indentation, loss of girth and shortening. Neurovascular bundles (NVB) lesion and, afterward glandular parestesia are the most common complications performing corporoplasty; certainly it cause patient general dissatisfaction. Severe curvature can cause penetration problems, unconfortable intercourses and psycological discomfort leading to surgical procedure.
We report our experience in NVB preservation and corporoplasty about ventral penile congenital curvature performing Perovic plication technique and deep dorsal vein stripping together with ramifications.

Methods and results

From 01.2010 to 11.2012 in Nuova Villa Claudia Clinic , 28 patients affected by ventral congenital penile curvature, underwent surgical treatment . Mean age was 24 (range 16 – 32 years).
The curvatures were between 30 and 60 degrees.
To preserve NVB we performed a complete deep dorsal vein stripping together with her ramifications.
Perovic tecnique is an efficacy procedure to correct the recurvatum when the its angle is less than 60 degrees and penile lenght is acceptable. Tecnique consisted of a plication of the tunica albuginea performing a six passages S shape using a non absorbable twisted 2/0 wire creating bumps of the tunica albuginea.

Discussion

After 3 months surgical results and satisfaction of the patients have been evaluated performing IIEF-5 and Duplex US.
None of our patients referred erectile dysfunction; one patient showed a severe wound infection, 3 patients soft hypoesthesia, 5 palpable knots and stitches underneath the skin, 2 patients presents residual curvature (about 20 degrees), 3 penile shortening, 20 patients stated high satisfaction from the results of the procedure.
Performing recurvatum correction of ventral congenital curvature, deep dorsal vein stripping together with her ramifications showed good results about preserve glandular sensitivity. This technique would also prevent venous occlusive deficit, common in congenital ventral curvatures of larger penis.