Management of congenital penile curvature.
OBJECTIVE
The long-term results of the management in adulthood of congenital curvature of the penis (ventral, lateral and dorsal) without hypospadias using 3 different techniques are carefully evaluated based on our experience.


METHODS
A total of 116 patients were operated on for congenital curvature of the penis without hypospadias in adulthood between January 1985 and December 2004 of whom 87 (75%) (mean age 24 years) were available for evaluation by a telephone survey. A total of 54 ventral, 28 lateral and 5 dorsal penile curvatures were operated on with a mean followup of 89 months. Bend was managed with Nesbit's procedure in 18, plication in 7 and the Heineke-Mikulitz technique in 62 men.


RESULTS
There were no significant intraoperative or postoperative complications. Overall 81 of the 87 patients (93.1%) were successfully treated with 1 operation. Curvature recurrence was less common in patients treated with the Heineke-Mikulitz technique. There were no complaints of de novo erectile dysfunction, but 15 men complained of shortening of the penis and 4 experienced decreased sensation of the glans.


CONCLUSIONS
Although feasible in cases of different types of congenital curvature, in our 20-year experience chordectomy always reduced the bend but patients could never completely straighten the penis by themselves. Surgical correction was reported by patients to be highly successful using the Heineke-Mikulitz technique, and statistical analysis revealed it to be significantly better than plication or the Nesbit procedure in terms of palpable nodules, recurrence and overall satisfaction.
Nyirády
Peter
P
Department of Urology, Semmelweis University, Budapest, Hungary. nyiradyp@hotmail.com
Kelemen
Zsolt
Z
Bánfi
Gergely
G
Rusz
András
A
Majoros
Attila
A
Romics
Imre
I
D000293:Adolescent; D000328:Adult; D005832:Genital Diseases, Male / Q000151:congenital / Q000601:surgery*; D006801:Humans; D008297:Male; D010413:Penis / Q000002:abnormalities* / Q000601:surgery*; D013521:Urologic Surgical Procedures, Male / Q000379:methods*