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A mathematical model to predict the loss of length in patients undergoing plication corporoplasty for Peyronie’s disease

Introduction: Peyronie’s disease affects three to nine out of 100 men and can have significant emotional and sexual effects on patients and their partners. Treatment options vary but once the disease becomes quiescent they are predominantly surgical. The type of surgery adopted is dependent on the degree of angulation although no single procedure is without its disadvantages. Plication corporoplasty is one approach but patients experience and often complain of loss of penile length. We set out to devise a mathematical model that would allow us to predict the loss of length based on erect penile dimensions. Methods: By considering the bend in the erect penis as an arc, utilising the degree of curvature and the penile circumference at maximum angulation, we have been able to derive a simple equation using parameters that are easily obtained in the clinic. Results: Where L=length lost, C=circumference at point of curvature, Y=angle of curvature as measured by a goniometer: L = CY/180. We have then been able to create a quick reference table based on the average penile circumference (12–13 cm±5 cm). Conclusion: This formula provides a more scientific and accurate means to predict potential loss of penile length in patients undergoing plication corporoplasty. Although we recognise that applying a rigid mathematical model to a biological non-uniform pathology creates inaccuracies this is somewhat better than ‘by sight’ estimates, and will allow more informed counselling and consent for patients. As far as we are aware this is the first attempt to create a mathematical model to aid counselling for plication corporoplasty.