Revision Surgery for Penile Curvature: What to Expect - Urology

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Understanding revision surgery for penile curvature, particularly after an initial procedure like the plication technique, is crucial for patients who experience dissatisfaction with their surgical outcomes. In your case, where the curvature has shifted from right to left after the first surgery, it’s important to discuss what the second surgery entails and what you can expect.

Revision surgery typically involves addressing the complications or unsatisfactory results from the initial procedure. In your situation, the second surgery may involve either removing the old sutures and redoing the plication or creating new sutures in a different location to correct the curvature. The specific approach will depend on the surgeon's assessment of the penile anatomy and the nature of the curvature.

One common concern with revision surgeries is the potential for penile shortening. This can occur due to the nature of the surgical technique used, as well as the amount of tissue that is manipulated or removed during the procedure. In plication techniques, the goal is to create a more symmetrical appearance by folding the tunica albuginea (the fibrous sheath surrounding the erectile tissue). However, if the curvature is severe or if the initial correction was not adequate, the surgeon may need to take more aggressive measures, which could lead to some shortening.

Before proceeding with the second surgery, it is essential to have a thorough discussion with your urologist or surgeon. Here are some key points to consider:
1. Surgical Technique: Ask your surgeon whether the second surgery will involve removing the old sutures or if they will be placing new sutures in a different area. Understanding the technique will help you set realistic expectations.

2. Penile Length: Discuss the potential for penile shortening. Your surgeon should be able to provide insights based on their experience and the specifics of your case. They may also discuss techniques that minimize the risk of shortening.

3. Recovery and Healing: Inquire about the recovery process after the second surgery. Typically, patients can expect a similar recovery timeline to the first surgery, but it may vary based on the extent of the procedure.

4. Postoperative Care: Understanding how to care for the surgical site postoperatively is crucial for optimal healing and minimizing complications. Your surgeon will provide specific instructions regarding activity restrictions, hygiene, and follow-up appointments.

5. Expectations: It’s important to have realistic expectations about the outcomes of revision surgery. While many patients achieve satisfactory results, some may still experience residual curvature or other complications.

6. Psychological Impact: Consider discussing any psychological concerns you may have regarding the surgery and its outcomes. It’s normal to feel anxious about the results, and addressing these feelings with your healthcare provider can be beneficial.

In summary, revision surgery for penile curvature can be a valuable option for those dissatisfied with their initial results. It’s essential to have open communication with your surgeon regarding the specifics of the procedure, potential risks, and expected outcomes. By doing so, you can make an informed decision and prepare for the next steps in your treatment journey.