A retrospective study was conducted to evaluate the efficacy and complications of folding combined with superficial suspension ligament release in the treatment of flexure.

A retrospective analysis was performed on 49 patients with curvature angles between 25° and 60° who underwent surgical treatment at Peking University Shenzhen Hospital and Shenzhen University General Hospital from January 2018 to December 2022. Of these, 34 patients received folding combined with shallow suspension ligament release (elongation group), and 15 patients received conventional folding (routine group). The changes of bending Angle, erectile length, International Index of erectile function (IEF-5), patient's sexual satisfaction and partner's sexual satisfaction before and after surgery were compared between the two groups, and the operation time, postoperative hospital stay and postoperative complications were compared between the two groups.

There were no significant differences in age, course of disease, degree of penile curvature, length of penile erection, IIEF-S, and preoperative sexual satisfaction between patients and partners between the two groups (p>0.05). After operation, all patients with curvature were successfully corrected, and the average degree of curvature improvement in the conventional group was 33.7°±7.9°. The average improvement of penile curvature in the elongation group was 32.1 ± 8.5°, and the difference was not statistically significant (P > 0.05). The average penile length loss in the conventional group was 1.1 ± 0.5cm, and the average penile length increased by 0.9 ± 0.8cm in the extension group. The difference was statistically significant (P < 0.05). The sexual satisfaction of patients and their partners in IIEF-S, conventional group and extension group was improved after surgery, and the difference was statistically significant (P<0.05). The improvement degree of partner sexual satisfaction in the elongation group was 5.20 ± 2.38 points, which was better than that in the conventional group (3.89 ± 1.69 points), and the difference was statistically significant (p < 0.05). In the elongation group, the improvement of IIEF-S, patient sexual satisfaction and partner sexual satisfaction in patients with preoperative bending Angle > 30° was significantly better than that in patients with bending Angle ≤ 30° (p<0.05). The improvement degree of sexual satisfaction and partner satisfaction of patients with IIEF-S before surgery was < 21 points, which was significantly better than that of IIEF-5 ≥ 21 points before surgery, and the difference was statistically significant (p < 0.05).

Compared with conventional folding operation, folding operation combined with superficial suspension ligament release had similar effect on improving the degree of curvature, and both achieved satisfactory correction effect. The elongation group compensated for the loss of penis length caused by penile folding and improved sexual satisfaction for patients and their partners. In terms of improving sexual satisfaction of partners, folding combined with superficial suspension ligament release is superior to conventional folding. This study provides a new clinical option for surgical treatment of curvature, and selecting the right patient can achieve the best clinical results of combined surgery.