THE NESBIT PROCEDURE IN CONGENITAL PENILE CURVATURE:AN ANALYSIS OF THE OUTCOME IN 48 PATIENTS

Introduction To evaluate the results of the Nesbit operation in patients with congenital curvature of the penis. Patients and methods. Between October 1006 and September 2002, 48 patients (mean age 26 years) with congenital penile curvature underwent Nesbit procedure using introflected sutures of either 0 or 1 Maxon. Mean (range) penile deformity was 54° (30-1000). The deformity was ventral in 20 (42 %), lateral in 26 (54 %) and 2 patients (4 %) had a complex deformity (dorsolateral or ventrolateral). Of the 48 patients, 45 were reassessed by means of IIEF-5 questionnaire together with three questions about residual deformity, penile shortening and treatment satisfaction. The mean (range) follow up was 38 months (3-74). Results All the 45 patients reassessed were having sexual intercourse. An excellent or satisfactory result was obtained in 35 (78%) patients. The main causes for dissatisfaction were residual deformity in 5 patients, penile shortening in 3 e cosmetic reasons in 2 patients. The penis was completely straight in 31 patients; there was a residual deformity of 10-30° in 12 and a deformity of more than 30° in 2 patients. There was no penile shortening in 18 men, a minor degree of shortening in 8, a shortening between 1 and 2 cm in 10 patients and > 2 cm shortening in 9. There was no postoperative erectile dysfunction (IIEF-5). Glans numbness was present in two patients and this resolved completely within three months after the operation. Conclusions The Nesbit operation represents the gold standard for the correction of congenital penile curvature but 20% of patients are not satisfied with the results of the operation and the main causes for dissatisfaction are residual deformity, penile shortening and cosmetical reasons