Decrease invasiveness of reconstructive surgery for congenital penile curvature

Previous topic - Next topic

0 Members and 1 Guest are viewing this topic.

Thiamine

https://www.ncbi.nlm.nih.gov/pubmed/29104792


Hi, do you think that it can be an interesting innovation compared to stage technique ? Thanks !

Abstract
INTRODUCTION:
The aim of the study was to report methods - based on penile anatomy - leading to the minimization in the invasiveness of reconstructive surgery for congenital penile curvature (CPC).

MATERIAL AND METHODS:
From 2006 to 2016 authors operated on 186 adult men with CPC.To avoid degloving, the authors used the longitudinal skin and tunica dartos incision. For decreasing invasiveness to the dorsal neurovascular bundle (NVB), the authors separated it only locally in the shape of a triangle or a trapezium, elevating it only over the place of the tunical reconstruction. To decrease the invasiveness for the tunica albuginea (TA) and cavernous vessels, a new operative technique based on the stratified structure of the TA was developed in which the corpora cavernosa were not opened. During reconstruction, only the elliptical fragment of the external layer of the tunica was excised (internal layer was left intact) and both layers of the tunica were sutured over the invaginated internal layer.

RESULTS:
Follow-up ranged from 6 months to 10 years. In all the patients, the penis was straightened during operation. Follow-up examinations were done 6 months and 1 year postoperatively. Disorders of superficial sensation on the glans, erectile dysfunction or chronic postoperative edema were not detected in any of the 186 patients. The penis remained straight in 180 patients (96.7%). In 4 patients (2.2%) in whom the primary curvature was 80-90 degrees and the postoperative curvature was about 30 degrees, reoperation was done. In two patients (1.1%) with the remaining postoperative curvature up to 20 degrees and good functional result (patient's opinion), there was no need for further treatment.

CONCLUSIONS:
Longitudinal skin and tunica dartos incision on the convex surface of the penis allows for the ability to avoid penile degloving and to preserve the foreskin. Elevation of the dorsal NVB from the TA was done on a very limited surface in the shape of triangle or trapezium, in order to decrease the possibility of dorsal nerves/vessels damage. Excision of elliptical fragments of the external layer of the TA with subsequent invagination of the internal layer, excluded the need for opening of the corpora cavernosa as well as for the use of a tourniquet during reconstruction. This diminished the potential risk of complications, especially intra- and postoperative bleeding.

JohnWright

A) Yes
B) Now, find a doctor accessible to you who performs this
C) Report your journey here

I see you've been visiting the Forum since 2015. I take it you actually have congenital curvature? But you are procrastinating about getting a procedure done?


JohnWright

Just call it an old battle scar.

The incision marks will be miniscule. And who is staring at your dick with a microscope, anyway? Too busy doing other things with mine to give a rip about a scar.


Thiamine

Quote from: JohnW on December 25, 2017, 10:22:26 PM
A) Yes
B) Now, find a doctor accessible to you who performs this
C) Report your journey here

I see you've been visiting the Forum since 2015. I take it you actually have congenital curvature? But you are procrastinating about getting a procedure done?

Iam procrastinating because :

- I cannot afford yet a stage procedure with Franklin Kuehhas
- I still try to find a good urologist who operate with stage technique in France (operation would be totally free in France)
- It's just a 30° ventral curvature so i tried a lot to "forget" it but years after years i just become more frustrated in sexe relations
- I also dreamed about penile traction to managed it but never had the "patience" to try it

So.. 2018 will be the year. Just trying to find the best solution.. :-\



Jack1909

I will never try to fix such a slight congenital curvature. But of course it's up to you.
31 yrs old
Severe congenital curvature. 3 straightening surgeries
Big lump/stitch w/ left deviation after 2012 surgery
Severe Erectile Dysfunction after last one in 2014. Still crooked
Slightly improved w/ shockwave therapy
Looks like only one side of my penis works

LWillisjr

Jack1909,
Your comment does not make sense. I agree that slight congenital curves do not warrant the risk of surgery. But nowhere has the original poster indicated what his curvature or symptoms are.
Developed peyronies 2007 - 70 degree dorsal
Traction/MEDs/Injections/Surgery 2008
66y/o  14 years Peyronies free
[URL="[url="http://www.peyroniesforum.net/index.php/topic,895.0.html"]http://www.peyroniesforum.net/index.php/topic,895.0.html[/url]"]My History

TonySa

The article details some quite serious congenital curves, guess like peyronies they come in all different degrees as well.
PxD 2 yrs 9/16.  Failed all treatment. 9/11/18: excision, grafting & implant Dr Karpman MtnView Ca, AMS CX 18cm + 3-1cm RTEs.
Pump failed.  2/11/20 Dr Karpman installed Titan 22cm +1cm RTE.

damned


LWillisjr

Thismine was the original poster, I read all his posts. None of them specify his symptoms.
Developed peyronies 2007 - 70 degree dorsal
Traction/MEDs/Injections/Surgery 2008
66y/o  14 years Peyronies free
[URL="[url="http://www.peyroniesforum.net/index.php/topic,895.0.html"]http://www.peyroniesforum.net/index.php/topic,895.0.html[/url]"]My History

damned

It's just a 30° ventral curvature so i tried a lot to "forget" it but years after years i just become more frustrated in sexe relations

That's what he wrote.

LWillisjr

Developed peyronies 2007 - 70 degree dorsal
Traction/MEDs/Injections/Surgery 2008
66y/o  14 years Peyronies free
[URL="[url="http://www.peyroniesforum.net/index.php/topic,895.0.html"]http://www.peyroniesforum.net/index.php/topic,895.0.html[/url]"]My History


Thiamine

It's a slight curvature but a ventral curvature.. A dorsal curvature pobably would not be a problem..

But if don't have a 100% erection the penis bends down and accentuates a lot the curvature and that's a problem.

LWillisjr

Yes, I completely understand that a ventral curve is tougher to deal with.
Developed peyronies 2007 - 70 degree dorsal
Traction/MEDs/Injections/Surgery 2008
66y/o  14 years Peyronies free
[URL="[url="http://www.peyroniesforum.net/index.php/topic,895.0.html"]http://www.peyroniesforum.net/index.php/topic,895.0.html[/url]"]My History