Masahiro Takeda1, Shogo Seo2, Ryo Sueyoshi2, Hiroki Nakamura2, Kazuto Suda2, Geoffrey J Lane2, Atsuyuki Yamataka2. 1. Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan. mstakeda@juntendo.ac.jp. 2. Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
Abstract
PURPOSE: There are surprisingly few reports about reconstructive surgery for severe recurrent/persistent penile curvature (redo-PC). We present our experience. METHODS: We reviewed 9 redo-PC cases we treated between 1998 and 2016. RESULTS: Cases 1-3 and 5 were identified from 111 consecutive hypospadias patients we treated between 1998 and 2016 (4/111; 3.6%). Cases 4 and 6-9 had initial surgery elsewhere. Initial PC was severe (> 45°; n = 5), moderate (30°-45°; n = 1), or unknown (n = 3), treated by dorsal plication (DP) in 4/9 (cases 1-4), chordectomy in 2/9 (cases 5, 6), and unknown in 3/9 (cases 7-9); no case had tunica albuginea incision (TAI). Straightening after initial surgery was confirmed by artificial erection (AE) in 4/9, not confirmed (2/9), and unknown (3/9). Cases 1, 2, 7 and 8 had had previous failed redos. Scarring of buccal mucosa used for urethroplasty caused worse PC in cases 7 and 9. After TAI (n = 6; cases 1, 3-6, and 8) or scar removal with DP (n = 3; cases 2, 7, and 9), AE confirmed successful straightening in all cases, without sequelae after a mean follow-up of 2.6 years. CONCLUSION: TAI was most effective for redo-PC surgery. Preoperative AE and examination under anesthesia should be used to customize treatment.
PURPOSE: There are surprisingly few reports about reconstructive surgery for severe recurrent/persistent penile curvature (redo-PC). We present our experience. METHODS: We reviewed 9 redo-PC cases we treated between 1998 and 2016. RESULTS: Cases 1-3 and 5 were identified from 111 consecutive hypospadiaspatients we treated between 1998 and 2016 (4/111; 3.6%). Cases 4 and 6-9 had initial surgery elsewhere. Initial PC was severe (> 45°; n = 5), moderate (30°-45°; n = 1), or unknown (n = 3), treated by dorsal plication (DP) in 4/9 (cases 1-4), chordectomy in 2/9 (cases 5, 6), and unknown in 3/9 (cases 7-9); no case had tunica albuginea incision (TAI). Straightening after initial surgery was confirmed by artificial erection (AE) in 4/9, not confirmed (2/9), and unknown (3/9). Cases 1, 2, 7 and 8 had had previous failed redos. Scarring of buccal mucosa used for urethroplasty caused worse PC in cases 7 and 9. After TAI (n = 6; cases 1, 3-6, and 8) or scar removal with DP (n = 3; cases 2, 7, and 9), AE confirmed successful straightening in all cases, without sequelae after a mean follow-up of 2.6 years. CONCLUSION: TAI was most effective for redo-PC surgery. Preoperative AE and examination under anesthesia should be used to customize treatment.
Authors: Erin R McNamara; Anthony J Schaeffer; Tanya Logvinenko; Catherine Seager; Ilina Rosoklija; Caleb P Nelson; Alan B Retik; David A Diamond; Marc Cendron Journal: J Urol Date: 2015-05-09 Impact factor: 7.450
Authors: Luis H P Braga; Armando J Lorenzo; Darius J Bägli; Sumit Dave; Kurt Eeg; Walid A Farhat; João L Pippi Salle; Antoine E Khoury Journal: J Urol Date: 2008-08-21 Impact factor: 7.450