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Prof. Dr. Ali Avanoğlu
Hypospadias Surgery • Surgical Techniques

Penile Curvature Correction Methods: Plication and Grafting

There are two main ways to correct penile curvature, and the choice is based on the measured angle and the patient's priorities: shortening the top surface (plication) or lengthening the underside (a graft).

Who this is forThose planning penile curvature correction
Reading≈1 min
ByProf. Dr. Ali AvanoğluUpdated
This page is part of hypospadias surgery.Read the full treatment overview on the hub page
straight
Straight
≈30°
≈30°
≈55°
≈55°
≈75°
≈75°
degrees of curvature
01 · The stepwise approach02 · Dorsal plication03 · Lengthening the underside with a graft
In brief3 madde
  • The stepwise approach: 1.
  • Dorsal plication: Sutures placed on the top surface of the penis balance out the length mismatch.
  • Lengthening the underside with a graft: The shorter underside is lengthened by adding tissue.
01

The stepwise approach

  • 1. Skin release (degloving) — curvature caused by tightness is eliminated at this step.
  • 2. Clearing the fibrous band — the second source of curvature is removed.
  • 3. The artificial erection test is repeated; the remaining angle is measured.
  • 4. Plication or a graft, depending on the remaining curvature.
02

Dorsal plication

Sutures placed on the top surface of the penis balance out the length mismatch. It's a simple, quick, and reliable method that doesn't require additional tissue.

  • The expected result is some shortening in length. This is something that must be discussed before surgery. It's preferred for moderate curvature.
03

Lengthening the underside with a graft

The shorter underside is lengthened by adding tissue. Length is preserved, but the procedure is more extensive and good erectile rigidity is expected.

  • It comes into consideration for significant curvature and in cases where losing length is unacceptable.
Related videos
Full guide (19) →
Frequently asked questions
How much shortening occurs?
With plication, the amount of shortening is related to the angle being corrected and can be estimated from pre-operative measurements. It's reasonable to ask your doctor for this estimate.
Is the goal zero degrees?
No. The general standard is achieving enough straightness that function isn't impaired. A very slight remaining curvature that doesn't affect function is acceptable.
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Related pagesFull index →
BasicsHypospadias and Penile Curvature (Chordee)Curvature is the second key determinant in hypospadias, after the position of the opening. Repairing the channel without first correcting the curvature only builds it on a penis that stays bent — that's why the order is always: curvature first, channel second.Follow-up and AssessmentWhat Is the Artificial Erection Test?The true degree of curvature can only be measured during an erection. The artificial erection created during surgery by injecting saline is how this measurement is made reliably.After SurgeryRecurrent Penile CurvatureCurvature reappearing after surgery can be seen especially as the child grows. The cause is often not that the first operation fell short, but that a previously hidden mismatch becomes apparent as the penis grows.Hypospadias in AdultsHypospadias + Penile Curvature in AdultsIn adults, curvature is not only a matter of appearance: past 30 degrees it can make intercourse difficult and cause pain. The degree of curvature determines whether correction is needed before the channel repair.
Hypospadias Surgery topic clustersMain treatment page →
Basics 8Surgery in Children 8Surgical Techniques 5After Surgery 9Recurrent Cases 4Hypospadias in Adults 8Follow-up and Assessment 5
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