Ultrastructure of the tunica albuginea in congenital penile curvature

Purpose: We investigated the ultrastructure of the tunica albuginea in indi viduals with congenital penile curvature to explain the pathology of this d isease. Materials and Methods: Included in our study were 15 patients 17 to 24 year s old with congenital penile curvature. Study material consisted of samples of the tunica albuginea excised from the greater curvature of the corpus c avernosum during surgical correction. Control samples were obtained from th e lesser curvature on the side opposite the study material during the same operation. The 2 types of tissue were analyzed using transmitter electron m icroscopy. Results: Ultrastructural examination of the control material revealed numer ous collagen fibers that were homogenous in size and organization on cross section. Periodic striation was typical in collagen that produced fibers. I n the study group the tunica albuginea structure,had a chaotic pattern of c ollagen fibers that formed bundles with disrupted 3-dimensional organizatio n. Diameter of the fibers differed greatly on cross section. We observed pe riodic widening and fragmentation of collagen fibers with the complete disa ppearance of striation and transformation into electron dense, fibrous gran ulated material. Disrupted fibroblasts without cell membrane and cellular o rganelles between collagen fibers were also visible. There was elastin accu mulation without any morphological differences in the control and study gro ups. Conclusions: Our results show that ultrastructural changes in the tunica al buginea may cause congenital penile curvature, possibly by altering mechani cal properties.