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INTRODUCTION: Congenital penile curvature can present with both uniplanar and biplanar defects, the latter of which entails more technically demanding surgery. AIM: The study aims to demonstrate the efficacy and safety of our novel superficial tunica albuginea geometric-based excision (STAGE) technique based on multiple, small, superficial elliptical tunica albuginea excisions and geometrical principles for correcting biplanar congenital penile curvature. METHODS: The study represents a retrospective analysis of 145 patients with disabling congenital biplanar ventrolateral (n = 131; 90.3%) or dorsolateral (n = 14; 9.7%) curvature of the penis, which underwent stepwise STAGEs between June 2006 and March 2012. Multiple 3-mm elliptical excisions of the superficial tunica albuginea were performed without compromising the inner layer of the tunica albuginea, thus resulting in a stepwise correction of the curvature and improved distribution of the bending force of the curvature. MAIN OUTCOME MEASURES: Functional outcome regarding penile straightening, erectile function, and patient satisfaction were evaluated. Furthermore, clinical data concerning the early postoperative outcome were analyzed retrospectively. RESULTS: The mean follow-up period was 21 months (range 6-62 months). Mean age at surgery was 23.8 years (range 15-47 years). Mean degree of curvature was 65° (range 45-90°). There was no recurrent curvature. Complete correction of the penile axis was obtained in 98.6% (n = 143). No change in erectile function according to International Index of Erectile Function-5 score was visible (P = 0.748). The mean loss of penile length was 0.7 cm (range 0.3-0.9 cm). The excellent functional outcomes resulted in a high level of patient satisfaction, including improved self-esteem, libido, sexual intercourse, and psychosexual relief. Two patients had a residual curvature of up to 30° requiring a reoperation. No intra- or postoperative complications were encountered. CONCLUSIONS: We recommend the STAGE technique as the optimal surgical intervention for correcting both uniplanar and biplanar congenital deviations.

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UNLABELLED: Study Type--Therapy (practise pattern survey) Level of Evidence 3b. What's known on the subject? and What does the study add? Congenital penile deviation has become a relatively frequent finding due to a greater awareness of the problem among patients and physicians. Since the first surgical correction for congenital penile curvature was performed, many modifications have been implemented to overcome the disadvantages of the standard procedure and to improve functional results. Among the possible side effects of the original technique are postoperative erectile dysfunction, the development of painful nodules at the suture sites ('dog ears'), alteration of cutaneous sensibility and significant penile shortening. This study presents a novel approach for the correction of congenital penile curvature. We modified the conventional Nesbit technique by applying superficial tunica albuginea excisions, according to the geometric principles of the Egydio technique. OBJECTIVE: • To report our experience with a new technique for the correction of congenital penile curvature based on geometric principles. PATIENTS AND METHODS: • Between January 2006 and March 2011, 211 men with congenital penile curvature underwent our modified Nesbit technique. • The technique consists of an objectivation of the degree of curvature and distribution of the bending force by multiple, small, superficial, elliptical excisions of the tunica albuginea. RESULTS: • The overall success rate was 99.1%. • A residual curvature of less than 20° was reported in 5% (n = 11) of the cases; none of these patients opted for further surgical correction. • Residual curvature of up to 30° was observed in 0.9% (n = 2); these patients underwent a reoperation. • Acquiring or regaining the ability to perform sexual intercourse brought major relief and high rates of satisfaction and self-esteem. • No recurrence of a ventral curvature occurred. CONCLUSIONS: • Our modified Nesbit technique, consisting of superficial tunica albuginea excision according to the geometric principles of the Egydio technique, leads to rapid and excellent results due to an objectivation of the curvature. • It is a safe and valid alternative for the treatment of congenital ventral or ventro-lateral penile deviation.

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Os autores apresentam 01 caso de malacoplaquia renal em paciente do sexo masculino que foi tratado com nefrectomia com diagnóstico pré-operatório de neoplasia renal.

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Os autores apresentam 01 caso de endometriose vesical em paciente do sexo feminino, de 42 anos de idade, que apresentava quadro de dor abdominal e disúria importante. Foi tratada com sucesso por ressecçäo endoscópica vesical, histerectomia e ooforectomia.

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