Treatment of penile curvature — a retrospective study of 175 patients operated with plication of the tunica albuginea or with the Nesbit procedure

Objective To evaluate the outcome and complications after operative correction of sexually disabling penile angulation. Patients and methods Between January 1 1987 and December 31 1991,175 patients underwent operative correction of penile angulation due to Peyronie's disease (57 patients) or congenital curvature (118 patients). Thirty two patients were treated by plication of the tunica albuginea and 143 by the Nesbit procedure. Post-operatively 91% of the patients were seen in the out-patient clinic after 3–5 months. A questionnaire sent to all patients 6–60 months after surgery was returned by 74% of the patients, and the present Results are based on the most recent information obtained. Results In the plication group good or acceptable results were obtained in 12 of 32 patients (38%) after the first operation, and in a further nine patients (22%) after a second operation. In the Nesbit group 126 of 143 patients (88%) obtained good or acceptable Results after the first operation and a further seven patients (5%) reported success after a second operation. The failures in the Nesbit group were due mainly to post-operative erectile dysfunction in patients with Peyronie's disease, in contrast to the plication group where failures were primarily due to recurrence of angulation. Conclusion Operative correction of penile curvature is a reasonably safe procedure, but should not be performed solely for cosmetic reasons. In the present retrospective study the results were better after the Nesbit procedure compared with plication of the tunica albuginea. However, a review of the literature does not give support to one operative technique over the other. This can only be clarified by performing a prospective randomized trial.