Corporoplasty

• Simple corporoplasty: are surgical techniques that provide for the straightening of the penis without the removal of any scar typical of induratio penis plastic; allow excellent aesthetic results. They are classically indicated for the correction of congenital penile curvature.

• Corporoplasty with plaque surgery: they involve the removal of fibrotic tissue and its replacement with different materials. They are generally associated with a good aesthetic result with shortening which, although always present, is typically well accepted by patients. Long-term studies have shown an increase in erectile dysfunction in patients undergoing this type of surgery.

In the first case various surgical techniques are available. The operation is performed under loco-regional anesthesia or in some cases in general and generally involves the creation of elliptical incisions on the lining of the cavernous bodies on the side opposite the curvature by suturing the margins according to the Nesbit technique or by making a longitudinal incision and a subsequent transversal suture (Yachia technique). The number and precise location of these incisions are established during the operation on the basis of the extent of the curvature assessed by means of artificial erection which will also be practiced at the end of the operation to evaluate the result. At the end of the surgery, a circumcision is performed. A bladder catheter will be placed and a compression dressing performed which will be removed together with the catheter after 24 or 36 hours. The inevitable consequence of the intervention is a reduction in length of the organ of about 1-2 cm. After the operation it is advisable to abstain from sexual intercourse for about a month. Possible complications are represented by ecchymoses, hematomas, infections and diastasis (opening) of the wound, recurrence, pain.

In the second case, the surgical treatment of Peyronie’s disease must be carried out with the disease apparently stabilized in the absence of painful symptoms, providing for the correction of the recurvatum and the restoration of sexual function. It essentially uses three therapeutic modalities:

– shortening surgery: involves the removal of lozenges of albugineum tissue or the positioning of plication stitches contralaterally to the plate, the site of the curvature, to allow the straightening of the penis by acting on healthy tissue. necessarily involves a .reduction in the length of the rod

– lengthening surgery: involves the incision/remodeling of the fibrosclerotic tissue at the point of maximum deformity. Prevede then involves the grafting of autologous (graft) or heterologous (patch) materials into the site of the remodeled albugineum tissue. The graft serves to cover the cavernous tissue underlying the covering defect that occurs on the tunica albuginea in relation to the remodeling incision. In any case, the operation will never restore the length of the penis present before the development of the disease.

– prosthetic surgery, in the case of complete/partial erectile dysfunction and rod deformity.