title: Correction of congenital penile curvature using modified tunical plication with absorbable sutures: the long-term outcome and patient satisfaction.
abstract: OBJECTIVE
  Although plication of the tunica albuginea with nonabsorbable sutures is an effective method in correcting congenital penile curvature (CPC), suture-related complications may happen. We investigated the long-term outcome and patient satisfaction of a modified tunical plication technique using absorbable sutures.
  
  
  METHODS
  From January 1999 to July 2005, 114 consecutive patients with CPC treated with a modified tunical plication technique by a single surgeon were retrospectively reviewed. With the modified corporeal plication technique, two, interrupted, U-shaped sutures with 2-zero polyglactin were applied to create bumps on the tunica albuginea. The long-term outcome and patient satisfaction were assessed by a post hoc questionnaire interview.
  
  
  RESULTS
  Among the 114 patients, complete straightness of the penis was achieved in 65 (57%) patients, and 33 (29%) patients reported a 15-degree or less residual or recurrent curvature at 6 mo postoperatively. Although 32 (28%) patients experienced suture failure (median time: 38.5 d), only half of them had a residual or recurrent curvature greater than 15 degrees. Younger patients (<24 yr) had a higher chance of suture failure than elder patients (p=0.03). Among the 103 patients completing the questionnaire, no palpable suture knots, suture granuloma, erectile discomfort, or erectile dysfunction was reported (median follow-up time: 41.5 mo). Eighty-three (81.5%) patients were either very or moderately satisfied with the surgical outcome.
  
  
  CONCLUSIONS
  The modified technique using double, interrupted, U-shaped sutures and absorbable suture material is a simple and effective method for treating CPC. Suture-related complications rarely happen. The long-term outcome is satisfactory, and most patients are pleased with the procedure.
authors.affiliation: Department of Urology, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Ju-Ton
authors.initials: JT
authors.lastname: Hsieh
authors.forename: Shih-Ping
authors.initials: SP
authors.lastname: Liu
authors.forename: Yisheng
authors.initials: Y
authors.lastname: Chen
authors.forename: Hong-Chiang
authors.initials: HC
authors.lastname: Chang
authors.forename: Hong-Jen
authors.initials: HJ
authors.lastname: Yu
authors.forename: Chung-Hsin
authors.initials: CH
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D000328:Adult; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D017060:Patient Satisfaction; D010409:Penile Diseases / Q000151:congenital* / Q000503:physiopathology / Q000601:surgery; D010410:Penile Erection / Q000502:physiology*; D010413:Penis / Q000002:abnormalities / Q000503:physiopathology / Q000601:surgery; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D013536:Suture Techniques; D013997:Time Factors; D016896:Treatment Outcome; D013521:Urologic Surgical Procedures, Male / Q000379:methods*