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Shaeer's corporal rotation III, modification of the original technique. Shaeer IV, a new twist

Garcia-Baquero, R1; Fernandez Avila, CM1; Parra Servan, P1; Ojeda Claro, AV1; Flor Peña, A1; Agüera Bitaube, J1; Rosety Rodriguez, J1; Leon Delgado, C1; Ledo Cepero, MJ1; Soto Villalba, J1; Soto Delgado, M1; Madurga Patuel, B1; Alvarez-Ossorio Fernandez, JL1

1: Hospital Universitario Puerta del Mar, Cadiz, Spain

Objective. Surgical treatment of congenital ventral curvature through the corporal rotation proposed by Shaeer provides the great advantage of avoiding shortening related to plication techniques, and also the risk of erectile dysfunction related to the incision and patch techniques. The last modification of the original technique is the noncorporotomy rotation (Shaeer III). Our goal is to make the technique more simple and adjustable and, therefore, more feasible. For that, we have applied the concept of intraoperative adjustment of the plication technique of the 16 dots described by Lue to the noncoroporotmy rotation described by Shaeer.

Material and methods. We present the video of a corporal rotation according to the modified Shaeer III technique. We performed this surgery on a 23-year-old male patient with congenital ventral penile curvature of 70º, a penile length of 17.5 cm and a baseline IIEF-EF of 18. The surgical technique is similar to the original one described by Shaeer. The difference lies in the location and approximation of the transverse plication points of the tunica albuginea after the mobilization of the neurovascular bandle. Cross lines of 4 points are marked, 0.5 cm from the midline, 1 cm between them and 1 cm from the point of maximum curvature. 3-5 tension lines on each side of the point of maximum curvature are usually enough, depending on the length of the penis. Subsequently, a 2/0 non-absorbable braided polyester suture is placed, outside-in and inside-out transversely. Sutures are knotted with a double knot and hold with a shod clamp. Maximum erection is induced with saline and the tension of the suture is adjusted to achieve complete straightening. Surgery is completed according to the original technique.

Results. Straightening was almost complete, with a residual curvature of 10º, a loss of length of 1 cm and of 0.5 cm of girth, without residual asymmetries nor associated complications. The IIEF-EF score is 23 after 3 months of follow-up.

Conclusions. The modification of the original noncorporotomy rotation technique described by Shaeer through the application of the concept of modulated plication proposed by Lue, simplifies the original surgical procedure, allowing the controlled adjustment of the rotation and making it feasible for more surgeons.

  

Disclosure:

Work supported by industry: no.

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