World J Mens Health.  2020 Oct;38(4):564-572. 10.5534/wjmh.190092.

Long-Term Results after Surgical Treatment of Congenital Penile Curvature Using a Modified Nesbit Technique

• Sokolakis I
• Schönbauer P
• Mykoniatis I
• Kübler H
• Gschwend J
• Lahme S
• Hatzichristodoulou G

• KMID: 2506421
• DOI: http://doi.org/10.5534/wjmh.190092

Abstract

Purpose
Congenital penile curvature (CPC) is a rare condition with surgical correction being the standard therapy. In the current study, we report long-term results analyzing the surgical and functional outcomes using a modified Nesbit technique.
Materials and Methods
Patients with CPC were included. After penile degloving and mobilization of the neurovascular bundle an artificial erection was performed. An ellipsoid part of the tunica albuginea was excised at the point of maximum curvature on the convex side of deviation. The tunical defect was then closed by interrupted absorbable sutures with inverted knots. Results of correction were documented intra- and postoperatively by artificial erection. Pre- and postoperative evaluation included measurement of penile length and curvature after pharmacological erection. Erectile function, alteration in glans sensation, palpable suture as well as short- and long-term complication were also recorded using validated questionnaires and objective examinations.
Results
Fifty-five patients with mean age 26.93 years (14–66 years) and mean curvature 69.81° (25°–90°) were included in the study. Ventral or ventrolateral curvature was observed in 83.6%. Mean operative time was 106.8 minutes (55–169 minutes). Totally straightness of the penis was achieved in 51/55 patients (92.8%). After a mean long-term follow-up of 36.68 months (4–87 months), erectile function worsened in 3.6% of patients. Median penile length loss associated with this technique was 1.7 cm (0–3.0 cm).
Conclusions
Surgical therapy of CPC using our modified Nesbit technique is feasible, safe and provides reliable long-term outcomes, representing an alternative for surgical correction of CPC.

Keyword

Congenital; Erectile dysfunction; Operative surgical procedures; Penile diseases; Penile induration; Reconstructive surgical procedures