Summary of Shaeer’s Corporal Rotation for Correction of Downward Penile Curvature Without Shortening
Penile deviation was customarily corrected by shortening the longer / convex side (shortening techniques). In the year 2006, Prof. Shaeer invented Shaeer’s Corporal Rotation , by which downward penile curvature is straightened without loss in length.
Shaeer’s Corporal Rotation is the only surgical technique that will correct any degree of ventral penile curvature without loss in length and without affecting erection. It is to be noted that Shaeer’s Corporal Rotation is suitable for ventral penile curvature ( a penis bent downwards ) and not for lateral penile curvature ( a penis bent to the left / a penis bent to the right ). It can also be performed if the penis is bent upwards ( dorsal penile curvature ).
Table of Contents
The penis has two erection cylinders; the corpora cavernosa. They are composed of thick walls ( the tunica albuginea ) full of vascular tissues that when filled with blood they become erect. When the penis is bent downwards ( ventral penile curvature ), the upper surface of the tunica albuginea is longer than the lower surface.
The classic techniques for correction of ventral penile deviation rely on shortening the upper surface. While the shortening techniques are feasible for many cases of penile curvature, they are not recommended for severe degrees of penile deviation since the shortening may be unacceptable.
What is Shaeer’s Corporal Rotation ?
For a case of ventral congenital penile curvature, Shaeer’s Corporal Rotation is performed by suturing the upper surfaces of the two erection cylinders together, rotating the erection cylinders inwards.
This shifts the downward curvature force of each cylinder sideways. So the contracted lower surface of the right cylinder will shift to the right, and the contracted lower surface of the left cylinder will shift to the left, thereby neutralizing each other.
The curved penis becomes straight without any loss in length. Girth ( diameter ) may show a minimal decrease but is always within the normal range and was never a complaint of any of the corporal rotation patients.
Advantages
Rotation of the corpora cavernosa corrects any degree of penile curvature while preserving the length of the penis
Disadvantages
There can be some minimal loss in circumference. This was addressed in the latest version : Shaeer’s Corporal Rotation IV. Other disadvantages common to most penile surgeries include a possibility of partial ( and usually temporary ) decrease in sensitivity, as well as a recurrence rate of 5-10%.
Who is corporal rotation for ?
- Cause of penile curvature: Congenital penile curvature
- Direction of penile curvature: Downward penile curvature ( Ventral penile curvature ) . Corporal rotation is not suited for lateral penile curvature. It can be performed in upward penile curvature ( dorsal penile deviation ) but will require mobilization of the urethra.
- Degree of penile curvature: Moderate degree penile curvature to severe degree penile curvature.
- Length of penis: Corporal rotation can be performed for a curved penis of any length. Erection: Good erection is a prerequisite
History of Shaeer’s Corporal Rotation Technique
Prof.Shaeer invented Shaeer’s Corporal Rotation in the year 2006 1. It was published internationally and well received by experts. Hundreds of cases of severe ventral penile curvature were corrected with Shaeer’s Corporal Rotation without any loss in length and without any loss in erectile function.
Since 2006, several experts started performing Shaeer’s Corporal Rotation with excellent results and published their results in scientific paper.
Timeline
Shaeer improved Shaeer’s Corporal Rotation along the years, from Shaeer’s Corporal Rotation-I to Shaeer’s Corporal Rotation-II to Shaeer’s Corporal Rotation-III, to Shaeer’s Corporal Rotation-IV.
Shaeer’s Corporal Rotation-I
In Shaeer’s Corporal Rotation-I , incisions were cut on the upper surface of both corpora cavernosa and sutured together.
Shaeer’s Corporal Rotation-II
This was developed into Shaeer’s Corporal Rotation-II 2 where one longitudinal incision was performed on the upper surface of each of the two erection cylinders and the two incisions sutured together. This achieved more uniformity in the diameter of the penis. In Shaeer’s Corporal Rotation-I, there may have been slight change in diameter of the penis between the parts with incisions and the parts without. In Shaeer’s Corporal Rotation-II, this was totally avoided.
Shaeer’s Corporal Rotation-III
Shaeer’s Corporal Rotation-III was published in the most prestigious Journal of European Urology 3. While similar to Shaeer’s Corporal Rotation-II in principle, it does not involve an incision in the corpora cavernosa. Rotation of the corpora cavernosa is achieved by permanent non-absorbable sutures passing from one erection cylinder to the other. Tying those sutures achieves corporal rotation and straightening the penis without shortening.
The advantages over rotation of the corporal bodies with Shaeer I and Shaeer II are that absence of internal incisions lends to shorter surgery, less pain, faster recovery and theoretically-speaking affect erectile tissue. This is called a non-corporotomy technique.
Furthermore, Shaeer’s Corporal Rotation-III without internal incisions allows the surgeon to fine tune and tweak the penis until satisfied. In the former corporal rotation techniques, the incisions are done, must be sutured, so no room for modification if needed. In contrast, with Shaeer’s Corporal Rotation-III , the surgeon can remove and re-place any suture as needed. Afterall, it is like painting a picture. You need to be able to re-touch it if required. This is of course during the surgery not afterwards.
Shaeer’s Corporal Rotation-IV
Shaeer’s Corporal Rotation IV 4 is the latest version of corporal rotation. It addresses all of the subtle drawbacks of previous versions:
- Minimal Shortening
- Minimal narrowing, way less than previous versions
- Inverted knots that are rarely detectable
How does Shaeer’s Corporal Rotation-IV decrease narrowing?
Prof.Shaeer observed that narrowing occurs at the very end of surgery when rotating for the last part of the penis curve. Shaeer’s Corporal Rotation IV minimizes narrowing by combining rotation and plication, in a ratio of 80:20. So, the curve is almost totally (80%) corrected by rotation, with minimal shortening, and the remaining mild deviation is corrected by shortening. Again, this is a non-corporotomy technique.
How does Shaeer’s Corporal Rotation-IV conceal the knots?
The knots in all four versions are hardly detectable, more so in Shaeer’s Corporal Rotation IV. This is achieved by placing an inverted suture, which when tied, has the knot directed inwards towards the penis shaft, rather than outwards towards the skin.
Watch Shaeer’s Corporal Rotation IV
Shaeer’s Corporal Rotation Before & After
Surgical Steps
Shaeer’s Corporal Rotation
Total Time: 45 minutes
Skin incision for corporal rotation
The skin incision for correction of congenital downward curvature of the penis by corporal rotation is a subcoronal incision, circumferentially under the glans penis .
Exposure
The skin and subcutaneous layers are pulled down to the base of the penis to reveal the erection cylinders (corporal cavernosa) and the point of maximum curvature of the penis. This is called degloving.
Induce Artificial Erection and evaluate penile curvature
The penis is injected with a vasoactive material to induce full erection such as Prostaglandin E1. Re-evaluate the degree and direction of curvature. Determine the point of maximum penile curvature.
Mobilization of the neurovascular bundle
The neurovascular bundle is composed of nerves and blood vessels that course on the surface of the corpora cavernosa. The bundle is set aside at the point of maximum penile curvature .
Rotation of the corpora cavernosa – Placing the rotation sutures / incisions
Rotation of the corpora cavernosa is achieved by approximating the upper surface of each corpus cavernosum to the other. This is performed in one of several ways:
– Shaeer’s Corporal Rotation I and Shaeer’s Corporal Rotation II: cutting incisions on the upper surfaces of both corpora cavernosa and approximating them by absorbable sutures
– Shaeer’s Corporal Rotation III: no cutting of the corpora cavernosa, but rather with permanent non-absorbable sutures
– Shaeer’s Corporal Rotation IV: no cutting, combined rotation and plication in a ratio of 80:20
Rotation of the corpora cavernosa – Tying the rotation sutures, or suturing the rotation incisions
The sutures are tied or the incisions are sutured to each other, approximating the upper surface of both corpora cavernosa to each other, thereby rotating them. Rotation straightens the penis with no or minimal loss in length.
Re-testing
Artificial erection is induced again to check that the curved penis has become fully straight.
Repositioning the neurovascular bundle
The neurovascular bundle is returned in place.
Skin closure
Skin and subcutaneous layers are sutured closed
Estimated Cost: 6000 USD
Frequently Asked Questions
What is Shaeer’s Corporal Rotation?
Shaeer’s Corporal Rotation is the technique that corrects severe downward congenital penile curvature with little or no effect on length, and no effect on erectile function. Invented by Prof. Osama Shaeer since 2006, and improved through four versions up to Shaeer’s Corporal Rotation IV.
Can Shaeer’s Corporal Rotation be performed in dorsal curvature ?
Yes, dorsal penile curvature can be corrected by rotation of the corpora cavernosa. However, this requires mobilization of the corpus spongiosum (the urethra) such that the rotation sutures are applied underneath the corpus spongiosum. Prof.Shaeer published this technique with excellent results, though he finds shortening techniques less invasive in dorsal penile curvature.
Can Shaeer’s Corporal Rotation be performed in lateral curvature ?
No. Lateral penile curvature is corrected with shortening techniques. However, if penile curvature is multi-axial, with both a ventral and a lateral curve, the ventral curve can be corrected by rotation, and the lateral with shortening.
Can Shaeer’s Corporal Rotation be performed in Peyronie’s curvature?
Yes, although there is not enough data on the correction of Peyronie’s curvature with rotation. A prerequisite is that there is neither hour-glass deformity or erectile dysfunction, two common findings in Peyronie’s cases.
When can I have sex after Shaeer’s Corporal Rotation?
Shaeer advises three months abstinence before sex to make sure healing is complete and to avoid pain during intercourse
Is surgery for correction of penile curvature painful?
Not on the long term. Some degree of pain is to be expected after any kind of surgery. If we classify pain as mild moderate or severe, pain after correction of penile curvature is mostly mild to moderate for a few days. After the initial convalescence and recovery, there can be mild pain on erection that may persist for several months. After that, no pain is usually encountered.
Can you feel the sutures used to correct penile curvature ?
If you search for them, you can find them, felt as a little firm mass under the skin. Nothing harmful, nothing that the partner should feel. Inverting the knots inwards helps concealing them. Using polyester instead of nylon sutures also helps.
What is the difference between Shaeer’s Corporal Rotation I, II, III & IV
– Shaeer’s Corporal Rotation I: Original technique, rotation by cutting small longitudinal incisions on both erection cylinders (the corpora cavernosa) and suturing them.
– Shaeer’s Corporal Rotation II: Rotation by cutting one longer longitudinal incision on each of the corpora cavernosa and suturing them. Advantage: better symmetry
– Shaeer’s Corporal Rotation III: Rotation without incisions on the corpora cavernosa, but rather with permanent sutures. Advantage: minimally invasive, speedier and easier recovery
– Shaeer’s Corporal Rotation IV: Combination of rotation and shortening in a ratio of 80:20. Advantage: Best balance between length preservation and width preservation.
Where Can I have Corporal Rotation Surgery performed ?
Prof.Shaeer, the pioneer of Shaeer’s Corporal Rotation; operates in his own hospital (Kamal Shaeer hospital) in central Cairo, Egypt.
References
- Shaeer O. Correction of penile curvature by rotation of the corpora cavernosa: a case report. J Sex Med. 2006 Sep;3(5):932-937. doi: 10.1111/j.1743-6109.2006.00203.x. Epub 2006 Jun 29. PMID: 16805787. ↩︎
- Shaeer O. Shaeer’s corporal rotation for length-preserving correction of penile curvature: modifications and 3-year experience. J Sex Med. 2008 Nov;5(11):2716-24. doi: 10.1111/j.1743-6109.2008.00913.x. Epub 2008 Jul 1. PMID: 18624969. ↩︎
- Shaeer O, Shaeer K. Shaeer’s Corporal Rotation III: Shortening-Free Correction of Congenital Penile Curvature-The Noncorporotomy Technique. Eur Urol. 2016 Jan;69(1):129-34. doi: 10.1016/j.eururo.2015.08.004. Epub 2015 Aug 19. PMID: 26298209. ↩︎
- Shaeer O, Shaeer K. Shaeer’s corporal rotation IV: length-preserving correction of congenital ventral penile curvature. J Sex Med. 2023 Apr 27;20(5):699-703. doi: 10.1093/jsxmed/qdad028. PMID: 37122108. ↩︎
Medical Author
Prof. Dr. Osama Shaeer
- Professor of Andrology, Cairo University
- Academician at the European Academy of Andrology
- Seventh President, Middle East Society for Sexual Medicine (MESSM)
- Multiple Awards in Surgical Andrology
- 60+ International Publications
Specialties
- Penile curvature surgery
- Peyronie’s disease
- Penile prosthesis surgery
