Investig Clin Urol.  2020 Mar;61(2):224-230. 10.4111/icu.2020.61.2.224.

Scrotal septum detachment during penile plication to compensate for loss of penile length compared with conventional surgical technique

Affiliations
  • 1Department of Urology, Korea University Guro Hospital, Seoul, Korea. dgmoon@korea.ac.kr

Abstract

PURPOSE
To evaluate the efficacy and safety of penile elongation featuring simple scrotal septum detachment from the penile base to compensate for the loss of penile length during penile plication in patients with Peyronie's disease compared with conventional penile plication.
MATERIALS AND METHODS
We conducted a retrospective analysis of 38 patients (24-75 years of age) with Peyronie's disease who underwent penile plication with or without our novel technique from January 2009 to May 2018. Penile elongation was achieved by release and detachment of the scrotal septum from the penile base to the level of the scrotal fat tissue. The objective outcome of change in stretched penile length (SPL) and the subjective outcome of patient perception of postoperative penile length were compared between groups. Any postoperative complications were recorded.
RESULTS
Of the 38 patients, 16 underwent penile plication with scrotal septum detachment (elongation group) and 22 underwent penile plication only (conventional group). The postoperative mean SPL was increased in the elongation group and decreased in the conventional group (1.2±1.3 cm vs. −0.5±0.3 cm, p<0.001). Fourteen of 16 patients (87.5%) in the elongation group reported perceived penile lengthening after surgery, whereas 17/22 patients (77.3%) in the conventional group complained of penile shortening. We encountered no procedure-related complications such as hematoma, infection, or necrosis in either group.
CONCLUSIONS
Simple detachment of the scrotal septum from the penile base afforded both objective and subjective penile elongation without any severe complications compared with conventional penile plication.

Keyword

General surgery; Penile induration; Penis

MeSH Terms

Hematoma
Humans
Male
Necrosis
Penile Induration
Penis
Postoperative Complications
Retrospective Studies

Figure

  • Fig. 1 (A) The dartos fascia (scrotal septum) that attached to the penile base ventrally. (B) Identification of areolar scrotal tissue (arrows) after scrotal septum release. (C) Immediate post-procedure appearance of scrotal septum detached penis. (D) Intraoperative gain of penile length immediately after procedure.

  • Fig. 2 Lateral penile appearance before and after penile plication combined with scrotal septum detachment. Note that the scrotum dropped downward and consequently penile lengthening is obtained.

  • Fig. 3 Diagram of the principle of penile elongation via our technique. Baseline penile length is marked with a “red arrow”; Newly obtained penile length via our technique is marked with a “blue arrow.”

  • Fig. 4 (A) Immediate post-procedure appearance of the scrotal septum detached from the penile base during penoplasty in a patient with concealed penis. (B) Preoperative appearance of a concealed penis and penile appearance at 3 weeks after the procedure.


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