WOFAPS 2025 8th World Congress of Pediatric Surgery

Harmit Ghattaura, Andre Stanley, Laura Jackson, Karim Awad, Mark Woodward, Mohamed Shalaby

Bristol Royal Hospital for Children, UK

Introduction

In STAC1 (STraighten And Close) repair, penile curvature (PC) is repaired by ventral degloving, urethral mobilisation and transection (UT), and three ventral corporotomies (VC) if there is residual chordee of >30-degrees. Our aim was to assess which contributes most to the correction of PC.

Method

Searches of prospectively maintained databases identified patients who underwent primary STAC1 repair between March 2021 and June 2024. Case notes were reviewed to collect the presented data.

Results

55 boys underwent STAC1 repair at a mean age 3y (1-7). Initial median curvature was 90-degrees (40–120) reducing to 70-degrees (30-110) after degloving, and then 60-degrees (25–100) after UT. Ventral lengthening by corporotomies resulted in mean 112% (40-320) increase in length; those with greater residual PC achieving greater lengthening (R²-0.23 p<0.0005). 32 boys underwent STAC2 with median PC 0-degrees (0-20). 5 patients (16%) needed dorsal plication at STAC2 for residual PC</=30-degrees. 1/55 patient required re-do single VC. Patients with pre-STAC1 PC greater than 90-degrees after degloving and UT were more likely to have PC greater than or equal to 60-degrees in comparison to the groups with less than 90-degrees (p<0.02), or equal 90-degrees (p<0.01).

Conclusion

Significant PC remains after degloving and UT; corrected fully by VC in 82% of patients rising to 97% after dorsal plication at STAC2. The more severe PC; the greater lengthening achieved by VC.

Table 1. Mean %reduction in PC