Single and multiple dermal grafts for thc e management of severe penile curvature

Bruce W. Lindgren*, Edward F. Reda, Selwyn B. Levitt, William A. Brock, Israel Franco

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

31 Scopus citations

Abstract

Purpose: Conventional techniques result in chordee correction in the majority of patients. However, some with extensive chordee require further treatment to correct persistent extraordinary penile curvature. Our practice has been to treat this condition with interpositional dermal grafting. We review our experience with this procedure. Materials and Methods: During a 5- year period dermal grafts harvested from the nonhair-bearing inguinal skin fold were placed in 51 patients with a mean age of 29 months. The primary diagnosis was penoscrotal or perineal hypospadias in 36 patients (hypospadias cripple in 4), the exstrophy-epispadias complex in 3, mid shaft or distal hypospadias with severe chordee in 10 and chordee without hypospadias in 2. A total of 49 patients (96%) underwent staged urethroplasty. Results: One graft was placed in 29 patients (57%), 9 (18%) received 1 graft and underwent a Nesbit plication, (14%) received 2 grafts, 5 (10%) received 2 grafts and underwent dorsal plication, and 1 (2%) received 3 grafts. Second stage urethral reconstruction was done using a Thiersch-Duplay tube in the majority of cases. In 5 patients mild residual chordee was easily corrected at the time of second stage repair. Conclusions: In a staged repair the first priority of the initial stage is to achieve a straight phallus. While our experience indicates that a single dermal graft is sufficient in approximately 57% of cases, when it does not result in complete straightening, we have had success with placing additional graft(s) and/or performing dorsal plication. We believe that the additional penile length achieved with dermal grafting results in a dependent phallus and cosmesis preferable to that of plication only.

Original languageEnglish (US)
Pages (from-to)1128-1130
Number of pages3
JournalJournal of Urology
Volume160
Issue number3 II
DOIs
StatePublished - Jan 1 1998

Keywords

  • Abnormalities
  • Hypospadias
  • Penis

ASJC Scopus subject areas

  • Urology

Fingerprint Dive into the research topics of 'Single and multiple dermal grafts for thc e management of severe penile curvature'. Together they form a unique fingerprint.

Cite this