Factors affecting the success of corporoplasty based on geometric principles in patients with congenital penile curvature

Abstract

Background: Data on factors affecting the success of incisional corporoplasty based on the geometric principles in congenital penile curvature (CPC) are limited. Aim: To compare the pubertal status (prepubertal and postpubertal), degree of curvature (<60 degrees and >= 60 degrees), direction of curvature (ventral, dorsal, lateral, ventrolateral), curvature plane (monoplanar or multiplanar) and to investigate the factors affecting success in patients who underwent incisional corporoplasty based on geometric principles due to CPC. Methods: A total of 79 patients who underwent incisional corporoplasty based on geometric principles between 2016 and 2024 in two tertiary care referral centers were evaluated. The surgical technique we apply to our patients is a modification of incisional corporoplasty. This technique is based on the geometric principles of the Egydio technique. Success was defined as complete satisfaction of the patient and/or patient's parent and absence of recurrence of curvature. Outcomes: Satisfaction, success, complication rates in patients who underwent incisional corporoplasty based on geometric principles due to CPC and comparison of these patients in terms of the pubertal status (prepubertal and postpubertal), degree of curvature(<60 degrees and >= 60 degrees), direction of curvature (ventral, dorsal, lateral, ventrolateral), curvature plane (monoplanar or multiplanar). Results: The success rate in our study was found to be 82.2% and the total complication rate was determined as 26.5%. The success rate was 90.5% in patients in the prepubertal period, and 79.3% in patients in the postpubertal period (P = 0.331). Success occurred 82% of patients with a curvature <60 degrees, while this rate was 82.8% in patients with a curvature of >= 60 degrees (P = 0.396). Success was found to be 75% for multiplanar curvature and 83.1% for monoplanar curvature (P = 0.626). In regression analysis, it was found that age (P = 0.185), puberty status (P = 0.263), degree of curve (P = 0.770), direction of curve (P = 0.927), presence of multiplanar curve (P = 0.573) and operation time (P = 0.924) did not affect success. According to Kaplan-Meier analysis the P-values for puberty status, degree of curvature, curvature plane and curvature direction were found to be 0.575, 0.720, 0.845, and 0.819, respectively. Clinical implications: Modification of incisional corporoplasty based on the geometric principles of the Egydio technique is an effective method in patients with CPC, regardless of age and curvature characteristics. Strengths and limitations: The lack of a group to compare this technique with other techniques, small sample size, the retrospective design of the study, the results being based on patient-reported results. The results discussed may cause bias because they are based on patient reports and do not include standard questionnaires. Conclusions: The geometrically modified incisional corporoplasty technique has a high success rate in patients with CPC up to 90 degrees, regardless of the patient's age, pubertal status, degree of curvature, direction, and whether it is multiplanar or not.