Extract

Objective

The function of the penile suspensory ligament (PSL) is to provide support to the erect penis to and maintain an appropriate angle for sexual intercourse, This paper describes the management of congenital and aquired abnormalities of the PSL.

Methods

A total of 124 patients that presented with a variety suspensory ligament abnormalities necessitating repair are included. The aetiology included: subsequent to sexual trauma (n=68), congenital penile curvature/ torsion (n=33), absence/laxity of the ligament (n=6), Peyronie’s Disease (n=8), venogenic erectile dysfunction (n=7) and penile dysmorphic disorder (n=2). The diagnosis was made clinically via a history and examination, instability on artificial erection testing and the presence of a palpable gap between the pubis symphysis and penis. Psychogenic ED was excluded using nocturnal rigiscan monitoring. The surgical repair involved placement of non-absorbable sutures between the tunica albuginea of the penis in the midline and the symphysis pubis. Ancillary proceedures of plication/grafting or venous ligation was also performed in 41 patients.

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