الفهرس 
AcknowledgementOnly 14 pages are availabe for public view
 |  | from | 111 |  |  |
| | | from | 111 | | |
Abstract
Congenital penile curvature is relatively an uncommon condition, characterized by congenital angulation of the erect penis, most commonly in the ventral and/or lateral direction. Patients usually present after reaching puberty as the curvature becomes more apparent with erections. Surgical correction of CPC is the gold standard therapy with a variety of surgical techniques and modifications. However, there is no gold standard technique that can be concluded from the previous studies and this notion represented our rationale to conduct the current study This study was a prospective hospital-based case series. It was done at the Urology Department, Assiut University Hospital, Assiut University, Assiut, Egypt between October 2017 and February 2020. The goal was to evaluate the results of incisionless tunical plication for correction of penile curvature, to study the predictors of outcomes and complications, and to assess patients’ satisfaction after incisionless tunical plication. The study included 23 patients with a mean (range) age of 25 (15-31) years. They had ventral penile curvature with a mean (range) degree of 40 (30-50), either, as isolated congenital curvature (21 patients) or after repair of hypospadias (2 patients). The median (range) of the preoperative erect penile length was 15 (10-19) cm. Eighteen patients (78.3%) were single at the time of presentation and operation. After completion of the routine work ups of clinical evaluation and surgical fitness, all the patients had correction via incisionless tunical plication. Besides the near postoperative care, they were followed up at 3, 6 and 12 months after surgery with evaluation for penile curvature and complications. The results showed that there was a significant improvement in the curvature angle from a median of 40 (30-50) to 5 (0-20) degree at 6 months and 10 (0-30) degrees at 12 months. Five patients only complained of recurrence of the curvature after 12 months. The penile length was affected with a median length of 15 cm preoperatively versus 14.5 cm postoperatively at 1 year. Postoperative complications included the early (within 1 month) complications such as penile pain in 13 patients (56.5%) and numbness in seven patients (30.4%) and wound infections in two patients (8.7%). Late complications included palpation of the sutures in 15 patients (65.2%) only. There were no reported erectile dysfunctions related to the surgery. No patients complained of numbness at 6 and 12 months at follow up. Seventeen patients (73.9%) were very satisfied with the surgical results. However, six patients were dissatisfied because of having a residual curvature of more than 15 degrees in five patients and suture palpation in one patient. There were no statistically significant factors affecting the rates of recurrence of penile curvature or postoperative complications. According to the above results, our study was similar to the literature in the demographic and clinical characteristics of the patients suffering from penile curvatures. Also, the operative and perioperative outcomes and complication rate were favorable and similar to their values in the previous studies. Limitations of our study may include the small sample size which was due to the rarity of the disease and the relatively short duration of follow-up. Most of our patients were single at the time of study and follow-up which made studying the effect on sexual intercourse inconclusive. However, the current study is a prospective one which could be an advantage relative to the retrospective methodology in the majority of the studies. In the present study, we conclude that the incisionless plication technique could be performed efficiently, safely, with a high success rate, low morbidity and a low complication rate.