title: The STAGE technique (superficial tunica albuginea geometric-based excision) for the correction of biplanar congenital penile curvature.
abstract: BACKGROUND
  Congenital penile curvature can present with both uniplanar and biplanar defects, the latter of which entails more technically demanding surgery.
  
  
  OBJECTIVE
  The study aims to demonstrate the efficacy and safety of our novel superficial tunica albuginea geometric-based excision (STAGE) technique based on multiple, small, superficial elliptical tunica albuginea excisions and geometrical principles for correcting biplanar congenital penile curvature.
  
  
  METHODS
  The study represents a retrospective analysis of 145 patients with disabling congenital biplanar ventrolateral (n = 131; 90.3%) or dorsolateral (n = 14; 9.7%) curvature of the penis, which underwent stepwise STAGEs between June 2006 and March 2012. Multiple 3-mm elliptical excisions of the superficial tunica albuginea were performed without compromising the inner layer of the tunica albuginea, thus resulting in a stepwise correction of the curvature and improved distribution of the bending force of the curvature.
  
  
  METHODS
  Functional outcome regarding penile straightening, erectile function, and patient satisfaction were evaluated. Furthermore, clinical data concerning the early postoperative outcome were analyzed retrospectively.
  
  
  RESULTS
  The mean follow-up period was 21 months (range 6-62 months). Mean age at surgery was 23.8 years (range 15-47 years). Mean degree of curvature was 65° (range 45-90°). There was no recurrent curvature. Complete correction of the penile axis was obtained in 98.6% (n = 143). No change in erectile function according to International Index of Erectile Function-5 score was visible (P = 0.748). The mean loss of penile length was 0.7 cm (range 0.3-0.9 cm). The excellent functional outcomes resulted in a high level of patient satisfaction, including improved self-esteem, libido, sexual intercourse, and psychosexual relief. Two patients had a residual curvature of up to 30° requiring a reoperation. No intra- or postoperative complications were encountered.
  
  
  CONCLUSIONS
  We recommend the STAGE technique as the optimal surgical intervention for correcting both uniplanar and biplanar congenital deviations.
authors.affiliation: Department of Urology, Medical University of Vienna, General Hospital Vienna, Vienna, Austria.
authors.forename: Franklin Emmanuel
authors.initials: FE
authors.lastname: Kuehhas
authors.forename: Paulo Henrique
authors.initials: PH
authors.lastname: Egydio
mesh_terms: D000293:Adolescent; D000328:Adult; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D017060:Patient Satisfaction; D010410:Penile Erection; D010413:Penis / Q000002:abnormalities* / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology; D011184:Postoperative Period; D019651:Plastic Surgery Procedures / Q000379:methods; D012189:Retrospective Studies; D013737:Testis / Q000601:surgery; D013519:Urogenital Surgical Procedures / Q000379:methods; D055815:Young Adult
keywords: Congenital Penile Curvature; Egydio Technique; Modified Nesbit; Penile Curvature; STAGE Technique; Tunica Albuginea