| WWW.CUREPEYRONIES.NET email:curepeyronies@yahoo.com |
 |
| |
 |
| |
 |
| |
 |
| |
 |
A Safe, Effective Surgical Technique for Correction of PD
Curvature?
This article appeared in the British Journal of Urology, (14
July 2009), and reviews the experience of one urologist, Allen
F Morey, who performed 48 corrective PD surgical
procedures over a 4 year period (2005-2009). Of these men,
34 had detailed penile measurements. Three of these men
were diagnosed with congenital penile curvature (cpc), the
remainder were PD patients. Dr. Morey is on the staff of the
University of Texas Southwestern, Department of Urology,
Dallas, Texas and has impressive credentials.
First some definitions:
- plication - state of being folded or tucked
- degloving - is a tearing away in which an extensive
section of the skin is completely torn from the underlying
tissue - imbrication - surgical pleating and folding of tissue to
provide extra support
The article points out that the majority of other urologists
who perform corrective surgery for PD or CPC use one of 2
procedures; either a 1) plication procedure (imbrication alone
without grafting) for deformities under 60 degrees using a
circumsing, degloving incision or 2) excision with a grafting
procedure for deformities + 60 degrees. In contrast, Dr.
Morey and his team at the University of Texas use a minimally
invasive approach, penoscrotal plication (PSP) with a small
penoscrotal incision even for complex deformities. In the
authors' opinion, it is simple, safe and effective. This
procedure is considered most effective for a dorsal curvature,
the curvature seen in the majority of men with PD.
This surgical procedure takes approximately 1 hour and is
considered complete when all members of the surgical team
agree that the curvature has been completely corrected.
Patients are released immediately after surgery and most are
able to return to work promptly. They were instructed to
return for a follow up in 4-6 weeks and barring any problems
that was it. The median range of curvature prior to surgery
was 45 degrees (20-80) and after surgery was 15 degrees
(0-25). (Note that curvatures in excess of 30 degrees are
when it usually interferes with intercourse). Complications
were rare and minor. Three men had erectile pain at + 6
weeks after surgery and one of those 3 men required suture
release for pain relief. This man had cpc and not PD. Another
man reported worsening of his condition and eventually had a
prosthesis inserted.
The authors go on to discuss the adverse effects of standard
corrective surgery. Briefly, there are high rates of ED, lack of
rigidity and penile shortening. None of the patients who
underwent their minimally invasive technique reported penile
shorting. The authors state that their procedure and findings
"debunk" several myths about surgical correction of PD
curvature; it results in shortening, severe curvatures are not
corrected by this surgery, penile skin must be degloved in
order for plication. They conclude that their procedure is a
safe and effective technique that is widely applicable for
reconstructing penile curvature.
As noted in many articles about our condition, there is no
standard treatment for surgical correction of PD curvature
and it seems urologists use whatever treatment method they
are most familiar with.
Fortunately, I have good insurance and can afford to travel
for medical treatment. I have seen a number of prominent
name urologists who specialize in PD and it has been
recommended to me that plication with degloving would be
appropriate, another suggested grafting and a 3rd said that
any procedure would have to be modified for my condition.
The authors of the British Journal of Urology article,
conclude that their minimally invasive procedure described
above appears to be a more effective, safer approach to
correction of penile curvature that the others commonly used.
I have one reservation about this article. The authors state
that their patients did not complain of penile shortening. As I
noted previously as is the usual case for all articles, there is
no mention of girth, either pre and post surgical.
