Shaeer’s Corporal Rotation-II: No-Corporotomy Technique

Background: Surgical techniques for correcting congenital penile curvature -without hypospadias- can be classified into three main categories: tunical shortening procedures with possible loss in length, tunical lengthening procedures with possible erectile dysfunction (ED), and penile prosthetics. Corporal rotation can correct the most severe degrees of congenital curvature without the fore mentioned drawbacks. This work describes modification and troubleshooting of corporal rotation aiming at simpler and less invasive technique, preserving length, girth symmetry and erectile function. Methods: The penis was degloved through a subcoronal incision. The neurovascular bundle was mobilized. Interrupted multifilament Polyester 3/0 sutures were placed bridging the dorso-lateral aspects of the corpora cavernosa, proximal and distal to the point of maximum curvature. The sutures were tied in the semi-erect state while bending the penis dorsally (counter to the direction of curvature) and with the assistant dipping the midline inwards by a haemostat to allow approximation of both corpora on top of the midline, achieving corporal rotation. Manoeuvres to address residual curvature, narrowing or girth asymmetry were employed. Results: Average pre-correction angle was 59.7° ± 12.8. Average post-correction angle was 0.9° ± 2.7. There was no statistically significant difference in penile length pre and post correction (p=0.07). There was a mild though statistically significant decline in girth following correction (3.4%, p=0.003). None of the cases showed girth asymmetry. Conclusion: The current modification of corporal rotation allows minimally invasive correction of severe degrees of isolated ventral or dorsal congenital penile curvature, preserving length and girth, and with relatively short abstinence from coital activity. Troubleshooting manoeuvres described help avoid residual curvature, girth asymmetry and narrowing.