STAGE : ​Superficial Tunica Albugina Geometric-based Excision

for the correction of Congenital  Penile Curvature

Our novel STAGE technique, consisting of superficial tunica albuginea excisions according to geometric principles, leads to rapid and excellent results due to an objectivation of the underlying curved penis. It is a safe and valid alternative for the treatment of congenital ventral, dorsal, dorso-lateral or ventro-lateral bent penis .

Why am I born with a curved or bent penis?

People who are born with a bent or curved penis (diagnosed as 'congenital penile curvature' condition) experience a mis-development of the penis during the embryology stage, causing one side of the penis to be longer than the other side. This leads to a curvature of the penis during erection, causing personal stress, potentially psycho erectile dysfunction, and sometimes loss of self confidence.

Is there a solution for my penile curvature problem?

Yes. The solution of any curved penis is based on surgery. There are many surgical procedures trying to solve this problem by making one side of the penis either longer or shorter than the other side. However, most of these techniques are based an old surgical concepts and may result in undesirable long-term side effects (complications), such as significant penile length loss, pain during erection, significant loss of sensation, bumps or lumps, and others.

The STAGE technique is a surgery primary focused on solving the congenital bent penis problem by relying on scientific geometric principles, leading to a very high success rate of the surgery without the mentioned complications above. 

The four steps of the STAGE  technique surgery

Step 1: Analysis of the Curved Penis based on Geometric principles

Shortening the longer side of the penis

The most effective way to treat a congenital curved penis is to shorten the longer side of the penis via small excisions, without losing much penile length. As a first step, the point of maximum curvature must be determined.

Determining the point of maximum curvature
To determine the point of maximum curvature of the penis, the STAGE technique relies on geometrical principles, unlike other techniques that rely on assumptions or guessing.


What is the Geometrical principle?
The intersection of both penile axis (yellow lines) determine the point of maximum curvature (P) at the convex side of the bent penis. The point of maximum curvature determines the location where the excisions should occur.

 

Step 2: Superficial Elliptical Excisions

The Tunica Albugina Layers

The tunica albuginea consists of an inner layer and outer layer and holds the blood during erection. Most surgical techniques will excise both layers of the tunica albugina to straighten a bent penis. The STAGE technique, only excises the outer layer of the tunica albuginea, to avoid complications seen in other techniques (e.g.,hematoma, excessive bleeding, major length loss, ...etc). In scientific terms, the STAGE excisions are superficial elliptical excision of the outer layer of the tunica albuginea avoiding potential side effects such as hematoma, excessive bleeding, indentations of the penile shaft, bulging defects ("dog ears") or significant penile length loss. 

Reaching the Tunica Albugina to perform the excisions

After we have determined the maximum point of curvature of the penis (Step 1), we need to perform the superficial elliptical excision of the outer layer of the tunica albuginea. To reach to the tunica albuginea however, we need to mobilize (put on the side) the layer holding the penile sensibility nerves (neurovascular bundle) which covers the tunica. Unlike other procedures, the STAGE technique ensures that the neurovascular bundle is not damaged, to avoid potential loss of penile sensibility.



Superficial Elliptical Excisions

After the neurovascular bundle is carefully mobilized, the tunica albuginea is exposed. Then, small 3 milli-meter elliptical excisions are made in the outer layer of the tunica albuginea where the point of maximum curvature was marked previously. 

Step 3: Closure of Excisions via Absorbable Sutures

Closing the superficial excisions
The elliptical excision of the superficial layer of the tunica albuginea
is followed by three absorbable sutures to close the newly generated tunical defect.



The STAGE technique relies on the natural healing capability of the human body to assure desirable long-term effects and to avoid other complications of non-absorbable sutures (used in other techniques), such as persistent palpable knots, bulging defects ("dog ears"), or pain during erections.

Step 4: Repetitions of steps 1, 2, and 3 for complete curvature correction

Complete correction of the curvature


Each step of the procedure (e.g., step 1, 2, and 3) has to be repeated until the complete correction of the axis of the curved penis is obtained.

Each step is based on the geometrical principles. This ensures an objective and reproducible surgery, that culminates into a very high patient satisfaction post-operatively.



Result: Initial and Final Appearane of the 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 patients suffering from congenital penile curvature.

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.

Empirical Results*

*       Kuehhas FE, Egydio PH. Superficial tunica albuginea excision, using geometric principles, for the correction of congenital penile    

            curvature.BJU Int. 2012 Dec;110(11 Pt C):E949-53

 

 

*       Kuehhas FE, Egydio PH. Superficial tunica albuginea excision, using geometric principles, for the correction of congenital penile    

            curvature.BJU Int. 2012 Dec;110(11 Pt C):E949-53

**       Syed AH, Abbasi Z, Hargreave TB. Nesbit procedure for disabling Peyronie's curvature: a median follow-up of 84 months. Urology. 2003    

           May;61(5):999-1003.

 

Video -  Stage Technique in Action

Advanced Center for Penile Curvature Treatment

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