STAGE : Superficial Tunica Albugina Geometric-based Exicison
for the correction of Congenital Penile Curvature
Our novel STAGE 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, dorsal, or ventro-lateral penile deviation.
Step 1: Geometric Curvature Analysis
The geometrical principle: from the point of maximum curvature (P) located at the intersection of the lines a-a’ and b-b’, a circumferential line is drawn at the bisection of the angle formed by these lines.
The point at which this circumferential line crosses the midline of the dorsal concave side of the penis determines the location of the superficial elliptical excision of the outer layer of the tunica albuginea.
Step 2: Superficial Elliptical Excisions
After neurovascular bundle mobilization (yellow arrow), the tunica albuginea is exposed. Small 3 × 2 mm elliptical excisions are made in the outer layer of the tunica albuginea where marked (blue arrows), to avoid complication such as hematoma and others.
The decision to mobile the neurovascular bundle is guided by an Ultrasound, to assure the avoidance of collateral vein damage which may result in poor erection post operatively
Step 3: Closure of Defects via Absorbable Sutures
Elliptical excisions of the superficial layer of the tunica albuginea (blue arrow) are followed by three absorbable sutures to close each tissue defect.
The STAGE technique relies on the natural healing capability of the human body to assure desirable long-term effects and to avoid the "dog ear" complications of non-absorbable sutures
Result: Initial and Final Appearane of Corrected Penis
We conclude that our novel STAGE technique, consisting of superficial tunica albuginea excisions, leads to rapid and excellent results due to objectivation of the curvature. In our opinion, this is an optimal treatment for congenital ventral, dorsal, or ventro-lateral penile deviation.
The excellent functional outcomes and lack of significant postoperative complications resulted in a high level of patient satisfaction, including improved self-esteem, relationships, libido and sexual intercourse.
* All patients were regularly followed up, after the surgical correction, for a mean of 19 months (range 6–60 months). The follow-up included self-photography using Kelami latero-lateral projections during a fully turgid erection.
Video - Stage Technique in Action