Surgical treatment options for curvature of the penis and our technique
Existing surgical techniques
There are basically four different surgical techniques that exist for treating curvature of the penis. We refuse to perform three of them, (techniques 1 – 3), as we are of the opinion that they are detrimental to patients.
However, for the sake of elucidation, we will explain all four methods to you. You will find them described below, along with our reasons for not performing specific techniques. We would like you to be able to make your decision freely on the basis of logic.
1st technique: Tucking techniques according to Nesbit, Essed-Schröder or Devine
To our disappointment, these are the techniques that most German doctors continue to perform. They are quick and easy to perform and require very little specialist knowledge. We cannot comprehend why patients continue to undergo these techniques even in this day and age.
In this technique, the healthy longer side is pulled and tucked using stitches, thereby shortening the penis. It is not uncommon for this to result in painful erections, particularly among younger patients, while this was previously not the case. Additionally, the strength of the erections can cause the stitches to tear after a short time.
Occasionally the surgeon tucks too much tissue, resulting in a curvature in the opposite direction and necessitating a further operation on (and additional shortening of) the penis. In most cases, the patient must remain in the hospital 5 to 7 days following this surgery so that the treating physicians can use medication to ensure as far as possible that the sutures do not tear during the first strong erections during this initial healing phase.
Moreover, cases of congenital curvature of the penis have more of an arced shape that affects the entire penis and cannot be straightened with a single purse-string suture, in contrast to an acquired curvature of the penis, in which the penis is generally bent at a sharp angle. Several purse-string sutures are therefore involved, leading to increased shortening.
2nd technique: Cross cuts/incisions with subsequent covering of the deformity with a saphenous vein graft or with artificial graft material
In this technique, the surgeon makes an incision into the shorter corpus cavernosum, allows the penis to expand and then covers the incision with a saphenous (vein) graft or a ‘patch’ (usually fascia tissue). Even though these techniques are definitely a more modern approach than the tucking technique, they are still incomplete from our perspective. The sole benefit is that the shortening of the penis is less pronounced.
3rd technique: Insertion of a (generally hydraulically-driven) penile prosthesis
Thankfully, this technique is only rarely employed. A prosthesis is inserted into the penis to maximise the tissue’s potential expansion. The results of this technique are final and irreversible, because the actual erectile tissue is effectively destroyed by the insertion of the prosthesis. The pump it uses then substitutes the normal erectile function.
The insertion of a prosthesis merely for the treatment of curvature is to be strictly rejected.
4th technique: Surgical reconstruction of the shorter corpus cavernosum
This is the surgical technique we employ to effectively treat curvature of the penis.
We reconstruct the affected parts of the corpora cavernosa through a highly involved surgery using non-artificial materials (usually high-quality collagen fleece).
According to our experience, this procedure is the only logical and sensible therapy option in the vast majority of cases.
It results in no visible scars on the penis. The scar is located in the same place as the circumcision scar so it is not noticeable on circumcised men. In rare cases it may be required to perform a simultaneous circumcision when the foreskin has become so narrow and restrictive that it could otherwise impair the results. We do not feel that generally performing circumcisions is sensible. An experienced surgeon can successfully retain the foreskin while avoiding the risk of infection or paraphimosis.
Due to the degree of difficulty involved, this technique can only be offered with satisfactory results in a few clinics in Europe that possess sufficient experience.
This technique was established over 20 years ago, so it is by no means new.
Our doctors have specialised in this technique, refining and further developing as they have performed it over the past 15 years. We are generally capable of satisfactorily treating cases that have even been pronounced irredeemable by other doctors.
We will be glad to provide you with information in a detailed and non-binding consultation on the options available for your specific case.
We are pleased that the majority of patients have grasped the benefits that our treatment offers. Our patients have tripled since 2006.