Combined penile plication surgery and insertion of penile prosthesis for severe penile curvature and erectile dysfunction.

Abstract

For persistent penile curvature after corporeal dilation and prosthesis placement other maneuvers, such as plaque incision with or without grafting, or penile modeling, must be used to complete penile straightening. However, each of these techniques is associated with increased morbidity, which includes higher rates of infection and urethral injury. We describe a new technique for correcting severe penile curvature and erectile dysfunction using combined penile plication and placement of a 3 piece inflatable penile prosthesis. Between February 2000 and June 2003, 5 patients with erectile dysfunction and severe curvature for which other treatment modalities had failed were treated with combined inflatable penile prosthesis and additional plication to correct the severe malformation. Detailed medical and sexual history was obtained as well as preoperative duplex ultrasound prior to surgery. The age range of our patient population was 22 to 55 years. In each case penile prosthesis placement was insufficient to correct the malformation and the addition of multiple plication sutures was required. The malformation in all patients was corrected with this technique. To date no patients have reported any complications with followup (range 3 to 36 months). In cases of severe penile deformity and curvature with erectile dysfunction the combination of penile plication and inflatable penile prosthesis placement is a method of repair that is well tolerated.