Shaeer, O, Shaeer, KM, Shaeer, K

Mobilization of the neurovascular bundle, penile curvature, peyronie’s disease

Neurovascular bundle mobilization (NVB) is one of the skills required for correction of penile curvature, whether congenital or acquired, with or without penile prosthesis implantation. NVB required experience and meticulous technique in order to avoid injury of the dorsal nerves and/or dorsal arteries of the penis. This work describes hydro-dissection of the neurovascular bundle (h-NVBm) aiming at a safer and faster procedure.

In H-NVBm, hydro-inflation of Buck’s fascia is performed prior to mobilization using 80% saline and 20% xylocaine (without adrenaline). The mixture is either injected into Buck’s fascia with a butterfly cannula inserted along the longitudinal axis of the shaft at several points, or with the blunt nozzle of a 20ml syringe, superficially applied to the surface of Buck’s fascia. NVB is then mobilized with alternating sharp and blunt dissection, aided with bipolar diathermy.

Hydro-dissection of the neurovascular bundle renders the procedure relatively safer and faster. While expert surgeons may be content with classic mobilization, hNVBm can be of particular importance to new entrants to of penile surgery.