BACKGROUND: Penile curvature is a common anatomic variant, one often congenitally associated with hypospadias. A third of children born with hypospadias will have concurrent clinically significant curvature. Severe penile curvature in the absence of a urethral anomaly is a rare occurrence. Isolated lateral curvature is even more uncommon. Numerous approaches have been described regarding the correction of penile curvature. Those most frequently discussed in the pediatric literature include isolated penile degloving, Nesbit plication, dorsal corporal plication, and ventral corporal lengthening. An alternate technique for curvature correction is the Lue plication. This was initially described as a method of correction of curvature caused by Peyronie’s Disease. This technique uses a series of parallel plication stitches on the contralateral side of the curvature to straighten the penis. This method offers a viable alternative for the correction of isolated penile curvature.
METHODS: The depicted patient is a healthy 9-year-old male with no history of hypospadias. He presents with recurrent 40-degree right to left lateral penile curvature. He previously underwent circumcision, Nesbit ellipse plication, and penile torsion correction at age 11 months. This film showcases the utilization of a modified Lue technique for curvature correction. A hemicircumcising incision was created and deepened to the tunica albuginea. An artificial erection test was performed and the point of maximal curvature was marked. Three rows of 4-0 Eithibond suture were placed in an and out fashion along four parallel dots opposite the point of maximal curvature. The needle enters at the first dot and exits at the second, this motion is repeated at dots three and four. Once the three knots were tied, the penis was noted to be straight at a second artificial erection test. The hemicircumcising defect was then closed in two layers.
RESULTS: Post-operatively, the patient experienced no complications and continues to have straight erections without curvature recurrence.
CONCLUSIONS: Use of the modified Lue plication technique proves to be a viable, durable, and cosmetically appealing solution for the correction of lateral penile curvature in the pediatric population.
