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STAGE technique

STAGE technique

The STAGE Technique (Superficial Tunica Albuginea Geometric-Based Excision) is a improvement of the original Nesbit operation and is used for penis straightening. Geometric principles help to objectify the curvature.

STAGE - Minimally invasive surgery for straightening of the penis

Continuous improvement of existing treatment methods is an integral part of modern medicine. Thanks to his specialization in treating penile curvatures, Dr. Kuehhas is well-acquainted with the topic and dedicated to the improvement of established techniques

Improvement of the technique

Thanks to his scientific research, Dr. Kuehhas played a key role in the development of the so-called STAGE technique (Superficial Tunica Albuginea Geometric-Based Excision). Carried out by expert hands, the conventionally used Nesbit procedure is a valid option of treatment, however, it is associated with significant side effects, such as loss of penis length.

Facts about Nesbit procedure

Straightening of the penis 58-100%
Shortening of the penis 41-90%
Somatosensory dysfunction 2-21%
Erectile dysfunction following the surgery 2-23%

Source: EAU Guidelines 2017

Goal of the STAGE technique

The STAGE techniques aims to achieve better results in straightening the penis while maintaining the length. The technique is based on geometrical principles, which allows to precisely locate the point of maximum curvature. At this point, maximum straightening can be achieved with minimal intervention.

Straightening the penis with the STAGE technique

Advantages of the STAGE technique

By applying geometrical principles, small excisions are being made (3x1mm each) on the outer layer of the tunica albuginea. This results in a more successful straightening of the penis, as compared to the Nesbit procedure. This is because the bending force of the penis is distributed among several small excisions during the STAGE technique whereas in the Nesbit procedure relies on a few big excisions. In such a case the stitches might break or cut through the tunica, consequently causing a recurrence of the curvature.
Furthermore, the STAGE technique is minimally invasive. During the procedure, the tunia albuginea is not perforated, leaving the erectile mechanism fully intact.

The STAGE technique in detail

1.

STEP 1:

Using geometric principles, the point of maximum curvature (P) is identified. It is situated at the crossing point of both axes of the curvature. At this point, maximum straightening can be achieved with minimal interference.

2.

STEP 2:

The point of maximum curvature (P) is marked. The tunica albuginea consists of two layers: the inner and the outer one. The tunica albuginea is not perforated during the procedure, which leaves the erectile mechanism intact.

3.

STEP 3:

On the tunica albuginea’s outer layer, an ellipse of the size of 3x1 mm is removed and the excision is closed with absorbable sutures.

4.

STEP 4:

Steps 1-3 are repeated until the penis is straight.

5.

STEP 5:

Following the successful straightening of the penis, all layers are repositioned.

Is the STAGE technique a viable solution for me?

During a consultation and examination, Dr. Kuehhas will be able to assess if your individual case requires surgical treatment.

 

Dr Franklin Kuehhas is a medical specialist in the field of urology and andrology. He received his specialization training at the University College London. He also underwent his training at the prestigious University Hospital in Heidelberg (Germany) and at the University Hospital of Vienna (Austria). Dr Kuehhas focuses on the treatment of congenital and acquired penile curvatures (Peyronie’s disease). His research activities have resulted in many publications and improvements of surgical techniques such as the STAGE technique for congenital penile curvature treatment.