The “Kiel Knots” Technique for Treatment of Congenital and Acquired Penile Deviation

Objectives: We propose a surgical correction of the penile curvature applying a technique based on the 16-dot plication technique modified by burying the knots in a shallow trough of incised tunica. We entitle this modification the “Kiel Knots”. Material and methods: 20 patients with a penile deviation, average age 36.8 years (24 52) were operated. Follow-up time was 26 months. In 8 patients the deviation was congenital, in 12 patients it was an acquired deviation. The deviation was >30 ̊ in all patients. Surgical technique: A circumcising incision was made and the penis was degloved. Buck’s fascia was incised exposing the tunica albuginea opposite the curvature. 8 dots were marked bilaterally on the tunica albugineaand a 5 mm incision along the marks was made without cutting into the Corpus cavernosum. Instead of plicating with one suture for 4 dots, our modification uses one suture for two dots with the knot buried in a shallow trough created by a scalpel. Results: The average operation time was 64 minutes. We observed a loss of penile length in 30% of the patients (0.5 1 cm). There were no problems with erectile function. In a follow-up of 2 years, 90% of the patients remained without recurrence of deviation. None of patients reported problems with the suture knots. Conclusion: Our technique achieves penile straightening with minimal loss of length and no erectile dysfunction.