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

Sokolakis, Ioannis; Schönbauer, P.; Mykoniatis, Ioannis; Kübler, Hubert; Gschwend, Jürgen E.; Lahme, Sven; Hatzichristodoulou, Georgios

doi:10.5534/wjmh.190092

Cited by 12 publications

(13 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Post-operative penile shortening is the most frequent complication of every plication and Nesbit procedures. In our study, the mean length loss was of 0.83±0.79 cm, in accordance to what was previously reported (35). Different to a previous study (36), penile shortening was not significantly associated to direction and degree of curvature.…”

Section: Discussionsupporting

confidence: 91%

“…On the other hand, satisfaction rate in our patients was slightly lower compared to the data described by Rolle (91.4% vs. 94%), probably because we treated also curvatures >60°. Moreover, in some studies erectile function raised up after surgery without reaching statistical significance, probably for the use of tourniquet during the technique and the prolonged time of penile ischemia (34,35). Rolle and colleagues did not consider the advantages of the penile clampless, probably because there was no scientific demonstration of the penile damage after a long period of ischemia at the time of the study (14).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Clinical and penile Doppler outcomes using a modified, tourniquet free, Nesbit plication for severe Peyronie’s disease

Altieri¹,

Greco²,

Lisanti³

et al. 2021

Transl Androl Urol

View full text Add to dashboard Cite

Background: Penile curvature (PC) can be surgically corrected by plication techniques or Nesbit corporoplasty. These shortening techniques can be complicated by post-operative: penile shortening, recurrent PC, palpable suture knots and erectile dysfunction. Furthermore, Nesbit procedures require the use of a penile tourniquet to avoid intraoperative bleeding. This observational study aims to assess the results of Nesbit modified corporoplasty, avoiding intraoperative use of tourniquet without risk of bleeding.The objective is to reduce penile ischemic anatomical and functional damages such as long-term erectile dysfunction.Methods: Between January 2010 and March 2019, a total of 64 patients with congenital penile curvature (CPC) and Peyronie's disease (PD) underwent surgical correction with a Nesbit modified technique first time described by Rolle et al., with minimal technical differences. The operation notes were retrospectively reviewed. In particular, we evaluated pre-and post-operative erectile functions using IIEF-5 score, penile Doppler ultrasonography and overall patient satisfaction.Results: During operations, no intraoperative bleeding was noted, and no short-term complications such as hematomas or neurovascular bundle lesions were reported. At 6 months, no palpable subcutaneous indurations and no sensory change were detected. Post-operative penile shortening was reported in 38 (59.4%) patients (mean 0.83±0.79 cm), but it did not influence the high overall satisfaction rate of 91.4%.Only 2 patients reported a slightly partial recurrence of curvature (<15%) with no need for a redo surgery.Mean IIEF-5 score increased from 17.1±5.2 to 20.8±3.9 at 6 months and 21.8±3.4 at 12 months (P<0.001 in both cases). Mean PSV also significantly increased at the end of follow-up (28.5±6.1 at baseline vs. 31.0±7.1 at 12 months, P=0.03).Conclusions: Considering the optimal results in terms of erectile functions increasing and absence of PC recurrence (>15°), we think that Nesbit modified corporoplasty without tourniquet application during reconstruction is a safe and effective surgical procedure for all kind of shortening corporoplasty to reduce the time of penile ischemia, preventing even serious consequences for the normal physiology of erection.

show abstract

Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Clinical and penile Doppler outcomes using a modified, tourniquet free, Nesbit plication for severe Peyronie’s disease

Altieri¹,

Greco²,

Lisanti³

et al. 2021

Transl Androl Urol

View full text Add to dashboard Cite

show abstract

“…Penile curvature is a congenital or acquired deformity which results in sexually debilitating condition and significant psychological stress for patients and their partners (15). Once medical treatment is excluded or unuseful, surgery becomes the standard of choice (16). Both shortening and lengthening procedures are good options for patients.…”

Section: Discussionmentioning

confidence: 99%

Prepuce-sparing corporoplasty as a safe alternative for patients with acquired penile curvature

Rose

Ambrosini

Mantica

et al. 2020

Arch Ital Urol Androl

View full text Add to dashboard Cite

Objectives: penile curvature is a rare condition, classified as congenital or acquired (Peyronie’s disease) (PD). Surgical correction is the standard treatment. It’s common practice to associate circumcision with penile de-gloving to prevent complications. In this paper we evaluate the feasibility of penile surgery avoiding circumcision. Materials and methods: patients presenting with penile curvature were treated using a modified Nesbit procedure. Patients were divided into group A if they opted for a prepuce-sparing surgery and the others into group B. Patients were evaluated pre and postoperatively and postoperative complications were assessed. The 5-item International Index of Erectile Function (IIEF-5) was administered before and 6 months after surgery and we compared the difference of mean value using T-Test. Results: Group A and B were made of 53 and 16 patients respectively. Median age was 59 years [interquartile range (IQR) 12] in A and 62 (IQR 9) in B (p = 0.2). Median curvature was 40° (IQR 40°) in A and 40 ° (IQR 30°) in B (p = 0.62). Mean difference between pre- and post-operative IEFF was 1.9 ± 2 in A and 2.6 ± 2.1 in B (p = 0.36). Conclusions: According to our experience, surgical correction of penile curvature without performing circumcision could be a safe and feasible strategy. We recommend performing circumcision only in patients who present with pre-operative phimosis.

show abstract

“…All studies demonstrated that the plication techniques for residual curvature during PPI seem to be safe and effective in patients with mild to moderate penile curvature. No article reported a classic or modified Nesbit technique (48). Still, the plication technique has always the risk of damaging the implant during suturing.…”

Section: Plication Techniquesmentioning

confidence: 99%

A comprehensive narrative review of residual curvature correction during penile prosthesis implantation in patients with severe erectile dysfunction and concomitant Peyronie’s disease

et al. 2021

Self Cite

View full text Add to dashboard Cite

Residual curvature correction during penile prosthesis implantation (PPI) is usually needed in patients with severe erectile dysfunction (ED) and concomitant Peyronie's disease (PD). The aim of the study was to assess the different existing techniques for treating residual penile curvature during PPI in patients with severe PD and ED. We generated a comprehensive narrative review of the literature until August 2020 on the use of PPI in combination with straightening reconstruction techniques, in treating patients with severe PD and ED. We included studies published in English, assessing the PPI as primary intervention in patients with PD and ED. Secondary research studies and studies with insufficient data were excluded from final analyses. We included a total of 33 clinical articles with 1,612 patients that assessed the effects of PPI combined with straightening surgical techniques for the treatment of severe PD and ED. Based on the severity of penile curvature, the concomitance of additional penile deformities (i.e., hourglass deformity), the penile length, the presence of previous penile operations and the surgeon's experience, four main categories of surgical techniques were identified: (I) PPI with plication of the penis on the convex side of the curvature, (II) transcorporeal plaque incision/excision, (III) PPI with plaque/tunical incision(s) on the concave side of the curvature and (IV) PPI with plaque incision/excision plus grafting. Patients with severe PD and ED can expect excellent outcomes with PPI and surgical correction of residual penile curvature and minimal side effects. Overall, all the above techniques seem to able to correct the residual penile curvature during prosthesis implantation. Grafting techniques seem to be favorable in patients with additional severe penile shortening. Still, no definite conclusions can be drawn regarding the superiority of one technique over the other.

show abstract

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

Cited by 12 publications

References 28 publications

Clinical and penile Doppler outcomes using a modified, tourniquet free, Nesbit plication for severe Peyronie’s disease

Clinical and penile Doppler outcomes using a modified, tourniquet free, Nesbit plication for severe Peyronie’s disease

Prepuce-sparing corporoplasty as a safe alternative for patients with acquired penile curvature

A comprehensive narrative review of residual curvature correction during penile prosthesis implantation in patients with severe erectile dysfunction and concomitant Peyronie’s disease

Contact Info

Product

Resources

About