Nesbit's operation was performed on 23 of 160 patients with Peyronie's disease seen between January 1975 and July 1978. Details of the preoperative treatment and operative technique are provided. Normal sexual intercourse was resumed by 20 of the 23 patients and none had a significant residual deformity. It is suggested that Nesbit's operation is the procedure of choice in patients who do not respond to conservative treatment.

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In order to study the pattern of male fertility in Noonan syndrome, and its potential implications for genetic counselling, the genital tract function was studied in 11 adult males with Noonan syndrome. Bilateral testicular maldescent occurred in six. The mean testicular volume was 21 (SD 4) ml. The stretched flaccid penile length was (SD 1P2) cm. Puberty was delayed in three. Four of the men had fathered children. The LH and testosterone levels were essentially normal in all men, while the FSH levels were grossly raised in the group with testicular maldescent, with the exception of one man. Semen samples were obtained from five men, and azoospermia or oligozoospermia was present in four of them. Sexual function is not affected in men with Noonan syndrome, but the onset of sexual activity was delayed in men with late onset of puberty. Bilateral testicular maldescent appears to be the main factor contributing to impairment of fertility in men with Noonan syndrome. (J Med Geniet 1994;31:468-470)

Summary. An . Of the 586 ova tested with spermatozoa from the infertile subjects only 11 (1\m=.\9%) showed any evidence of penetration (range of individual penetration rates 0\p=n-\8\m=.\7%) and binding to the vitelline membrane was poor (0 or <5 spermatozoa/ ovum). Spermatozoa from a further 9 infertile men who had abnormal spermiograms also gave poor penetration rates (4/300 ova, 1\m=.\3%). It is concluded that this bioassay has a useful role as an additional test to the classic spermiogram, but that its routine use is best reserved for selected cases of unexplained infertility.

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.

The concentrations of some inorganic ions (sodium, potassium, chloride and phosphate) and organic compounds (carnitine, myo-inositol, glycerophosphocholine, phosphocholine and total phosphate) were estimated in the luminal fluid collected from sections of human ductus deferens removed at vasectomy. From the data presented it would appear that in contrast to non-primate species, in the human the inorganic ions contribute more to the total osmolarity of the luminal fluid than do the organic compounds.

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