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

The World Journal of Men′s Health 2020년 38권 4호 p.564 ~ 572
Sokolakis Ioannis, Schonbauer Petra, Mykoniatis Ioannis, Kubler Hubert, Gschwend Jurgen, Lahme Sven, Hatzichristodoulou Georgios,
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 ( Sokolakis Ioannis ) - Julius-Maximilians-University of Wurzburg Department of Urology and Pediatric Urology
 ( Schonbauer Petra ) - Technical University of Munich Department of Urology
 ( Mykoniatis Ioannis ) - Aristotle University of Thessaloniki Department of Urology
 ( Kubler Hubert ) - Julius-Maximilians-University of Wurzburg Department of Urology and Pediatric Urology
 ( Gschwend Jurgen ) - Technical University of Munich Department of Urology
 ( Lahme Sven ) - Goldstadt Privatklinik Department of Urology
 ( Hatzichristodoulou Georgios ) - Julius-Maximilians-University of Wurzburg Department of Urology and Pediatric Urology

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.

키워드

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

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