Objective To analyse critically the reasons for a poor outcome of the Nesbit operation for Peyronie's disease in 51 patients over a 20‐year period. Patients and methods Fifty‐one patients who were classified as having a poor result from the Nesbit operation were reviewed (mean age 53 years, mean follow‐up 21 months). The factors responsible for a poor result were analysed and classified into three groups: (i) deformity > 30°; (ii) penile shortening > 2 cm; and (iii) impaired erection. Patients with a recurrent deformity were further classified according to the interval from surgery to the presentation of the recurrence. Results Thirty‐one patients had a deformity of > 30°; this occurred immediately in three patients through surgical error, soon after surgery in eight patients because of suture failure and after 11 months in the remaining 20 patients because their Peyronie's disease progressed. Penile shortening of > 2 cm was present in 19 patients but this only affected coital function in four. Erection was impaired in 10 patients but this was present before surgery in most. Conclusion The results of the Nesbit operation for Peyronie's disease can be improved by a preoperative assessment of erectile function and the use of sutures of high tensile strength. Patients should be warned that the disease may progress and that some penile shortening should be expected, although this does not affect coital function.

Objective: To assess the results of the correction of congenital penile curvature using the Nesbit operation. Patients and methods: The records of 106 patients who had a Nesbit operation to correct a congenital penile curvature between 1977 and 1992 were reviewed. Results: An excellent (78.3%) or satisfactory (17.9%) result was achieved representing an overall success rate of 96.2%. The reasons for a poor or satisfactory result were either an impaired erection Ð 7 (6.6%) [all psychogenic] or a residual deformity of 10 ± 16 (15.1%). There were no major complications although ®ve patients (5.3%) needed a further Nesbit operation. Conclusion: The Nesbit operation is a simple and effective technique for the correction of a congenital penile curvature.