PENILE LENGTH IN ADULTHOOD AFTER EXSTROPHY RECONSTRUCTION

Purpose: We attempted to determine whether the penis in adulthood afte r exstrophy reconstruction is short because of a congenital defect in the size of the corpora cavernosa. Materials and Methods: Pelvic magne tic resonance imaging was performed on 10 men who underwent exstrophy reconstruction in childhood, and 10 age and race matched controls. Mea surements of penile and pelvic anatomy were compared. Results: The cor pora cavernosa in men after exstrophy reconstruction were shorter than normal. Dividing total corporeal length into an anterior and posterio r segment revealed that the anterior segment was short but the posteri or segment attached to the pubic ramus was normal. However, the diamet er of the posterior corporeal segment was greater than in controls. Al though diastasis of the symphysis pubis increased the intersymphyseal and intercorporeal distances, the angle between the corpora cavernosa was unchanged, presumably because the corporeal bodies were separated in a parallel fashion. Conclusions: After exstrophy reconstruction the penis is short in adulthood, at least partially due to a congenital d eficiency of corporeal tissue. Since diastasis of the pubic symphysis and chordee decrease penile visibility, approximation of the pubic sym physis and procedures to straighten the penis may improve cosmesis. Ho wever, because the corpora cavernosa are short, after exstrophy recons truction the penis will always be shorter than normal in adulthood.