The Nesbit operation for penile curvature: an easy and effective technical modification

PURPOSE: We report the results of an original technical modification to the Nesbit operation, designed to increase precision and simplify the correction of congenital or acquired penile curvature. MATERIALS AND METHODS: A total of 50 patients were considered candidates for surgical treatment of penile curvature and underwent a modified corporoplasty procedure involving plication suture on the convex aspect of the penis before tunica albuginea resection. Hospital records and followup data were retrospectively reviewed. RESULTS: A total of 32 patients had congenital penile curvature with a mean angle of 48 degrees (range 40 to 90) and difficult vaginal penetration. Another 18 patients had Peyronie's disease with penile deformity with a mean angle of 48 degrees (range 40 to 60) without hourglass deformity or hinge effects. All patients had spontaneous and full erections. Mean operative time +/- SD was 62 +/- 15 minutes. No intraoperative complications were recorded. In all cases penile curvature was completely corrected. Neither residual curvature nor hypercorrection were recorded. Regarding erectile function, which was evaluated in the Peyronie's disease group, preoperative average International Index of Erectile Function-5 score was 17.83 +/- 4.17, whereas postoperatively it was 19 +/- 4.63 (p = 0.036). Regarding overall satisfaction, 3 patients (6%) with Peyronie's disease were unsatisfied. CONCLUSIONS: Our modified corporoplasty procedure results in an improved straightening outcome due to the possibility of performing tunica albuginea excision only after the surgeon has made and verified the exact correction in real time. A slight but statistically significant improvement in erectile function was observed in patients with Peyronie's disease.