Penile plication without degloving enables effective correction of complex Peyronie's deformities

Objective: To present our initial experience with extended plication repair for men with severe and/or biplanar penile curvature. Materials and Methods: A review of men who underwent plication repair for complex penile deformity (biplanar curvature or curvature ≥60°) was performed. All patients underwent tunical plication via a 2-cm penoscrotal incision mobilized distally along the penile shaft without degloving. Angle of curvature, direction(s), stretched penile length (SPL), and number of sutures were recorded. Results: Among 102 patients treated with plication surgery, 43 (44%) had complex penile deformity. Among 11 men with biplanar curvature, median angle in the primary plane of curvature was corrected from 45° to 10° and secondary plane was corrected from 35° to 5° using an average of 7 sutures (5° correction per suture). Among 32 men with severe curvature, median angle of curvature was corrected from 70° to 15° using an average of 11 sutures (6° correction per suture). SPL was unchanged in 29 (69%), increased an average of 0.65 cm in 7 (16%), and decreased 0.5 cm in only 6 (14%) patients. At a mean follow-up of 15.3 months, repeat plication was required in 2 patients and 2 required penile prosthesis. Conclusion: Penile plication without degloving appears to be safe and effective for correction of complex penile curvature without significant impact on penile length.