The curvature of the penis is a disorder that may block or impair the penetration during sexual intercourse. Curvatures can be congenital or acquired. The congenital curvature can be further divided in relation to the possible coexistence of position anomalies of the external urethral meatus (epi or hypospadias).
The curvatures with the urethral meatus position anomalies are usually corrected in pediatric age.
The curvature can be acquired following trauma and microtrauma of the corpora cavernosa or they may constitute the clinical epiphenomenon of a situation of induratio penis plastica (La Peyronie’s disease). In the presence of such a curvature of the corpora cavernosa of the penis it is preferable to carry out a straightening surgery.
The surgery is performed in loco-regional anesthesia (spinal, etc.) or general and involves, through an incision of the skin of the penis at the level of the coronal sulcus (with possible circumcision) or on the dorsal surface, the creation of elliptical incisions on the side opposite to the curvature suturing the margins in accordance with the Nesbit technique or performing a logitudinal incision of the corpus cavernosum and a subsequent transverse suture (Yachia technique) or by extending the ventral surface by means of the grafts (dermal, venous etc.).
The number and precise location of these incisions is determined during the surgery, on the basis of “recurvatum” assessed by artificial erection. The artificial erection will evaluate the occurred straightening of the penis during the surgery.
At the end of the intervention, after the application of a small bladder catheter as Foley 14-16 ch, a compressive dressing of the penis will be performed, which will remain in place for about 24 hours. The inevitable consequence of this intervention is the reduction of the length of the penis in erection, usually variable from about 1 to 2 cm.
The possible complications are bruising, hematoma, infection and wound diastasis. Sometimes residual fibrous scars at the level of the tunica albuginea may occur. Erectile dysfunction due to impaired venous dynamic or vascular lesions of nerve bundles is rare.
After surgery the patient will have to refrain from sexual intercourse for 4 weeks.