
- Max Brambilla
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Gyplast Medical Institute - Viale Luigi Majno, 18Milano
Clinica Planas - Av. Pere II de Montcada, 16Barcelona
Clinique Champel - Rue Firmin Massot, 12Ginevra
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info@massimilianobrambilla.itCongenital penile curvature
Penile curvature (recurvatum or griposis) is due to the abnormal development of the cavernous bodies. Most often, it is ventral, occasionally lateral, and rarely dorsal. It is often associated with hypospadias in the case of ventral recurvatum or epispadias in the case of dorsal recurvatum. In these cases, during erection, the penis tends to curve toward the bent side. The major issue is related to sexual intercourse, which can be quite challenging in such cases.

The surgical therapy for this condition is called “corporoplasty,” aiming to correct the abnormal curvature and align the shaft. There are three techniques:
Straightening corporoplasty: Involves the removal of portions of the tunica albuginea of the cavernous body on the convex side. In summary, the convex side is shortened, bringing it to the length of the concave side. However, this results in shortening, so the penis should be of at least average size.
Cavernosolysis: This technique elongates the shorter portion. Since the issue is often related to an excessively short urethra, it can lead to a condition known as surgical hypospadias. This means that due to the elongation, the urethra may be shortened, and it needs to be lengthened simultaneously or in a subsequent procedure. The advantage is that the penis lengthens without shortening, but the downside is the potential need for urethral reconstruction to lengthen the deficient segment.
In some cases, the use of dermal or saphenous vein grafts may be necessary to lengthen the “short” part, freed from the fibrotic area.
Acquired penile curvature (Peyronie's disease or Induratio Plastica)
It is a condition caused by the formation of a fibrous and inelastic plaque on the tunica albuginea, which is the lining of the cavernous body. During erection, the inelasticity of the plaque leads to a curvature of the shaft due to abnormal tension exerted on it.
The formation of the plaque is accompanied by an initial phase characterized by pain and the appearance of curvature, which gradually intensifies. In 50% of cases, the condition stabilizes, although in a smaller percentage, remission or worsening of the condition may be observed.
Medical therapies are recommended in the initial phase, while surgical interventions are indicated in confirmed and stabilized cases. Surgical methods include:
Corporoplasty: Recommended in cases of low to moderate severity with an appropriately sized penis. It involves correcting the concave part while leaving the plaque intact. In essence, it corrects the long arm of the shaft by shortening it, while leaving the short arm (with the plaque) unchanged.
Removal of the plaque and replacement with graft: Indicated in more severe cases. The removed plaque is replaced with a graft.
Insertion of a penile prosthesis: Indicated in some cases concurrently with the above procedures.

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