Peyronie's disease and congenital penile curvature: long-term results of operative treatment with the plication procedure.

Objective To evaluate the results of plication of the tunica albuginea in patients with a curved penis. Patients and methods Twenty-two men with congenital penile curvatures and 33 men with acquired penile curvatures were treated by the plication technique. Their files were studied and all patients underwent a follow-up interview and were physically examined. The mean age of the patients with congenital penile curvatures was 25.7 (range 17–58) and that of the men with acquired penile curvatures was 54.4 (range 28–67). The mean length of follow-up was 42 months. Results The mean angle of deviation in relation to the longitudinal axis was 48.2d in the congenital curvatures and 63.3d in the acquired curvatures. AU congenital curvatures were corrected successfully, i.e. the penis was straight and satisfactory intercourse was possible. Slight shortening of the penile shaft was noticed by eight patients, but none was concerned about this finding. Pre-operatively, 12 of 33 patients with acquired curvature were unable to have intercourse because of the combination of decreased rigidity and abnormal curvature. Of these patients, three were able to have satisfactory intercourse post-operatively. Most of the nine patients with a poor result were known pre-operatively to have adverse factors affecting erectile function. Of the 21 patients who were only able to have intercourse with difficulty pre-operatively, intercourse was easier and more satisfactory in 18 and more difficult in three post-operatively. Pre-operative pain with erection improved in all patients. Complications were mild. Shortening concerned only two patients with recurrent Peyronie's disease after re-operation. Conclusion Plication of the curved penis is a relatively simple, save and effective procedure.