The Nesbit operation for congenital curvature of the penis

Andrews, H.O.; Al-Akraa, Mahmoud; Pryor, J. P.; Ralph, DJ

doi:10.1038/sj.ijir.3900390

Cited by 39 publications

(23 citation statements)

References 8 publications

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“…30 In the setting of a ventral curvature, once Buck's fascia has been elevated, small wedges of the contralateral dorsal tunica albuginea are excised and then the defect is closed, typically with permanent suture. Variations on this approach have evolved, including the Yachia procedure, which utilizes the Heineke-Mikulicz technique.…”

Section: Tunical Shortening Proceduresmentioning

confidence: 99%

Surgery for Peyronie's disease

Levine¹,

Larsen²

2012

Asian J Androl

110

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Peyronie's disease (PD) is most simply referred to as a fibrotic wound-healing disorder of the tunica albuginea. It is both a physically and psychologically devastating disorder that causes penile deformity, curvature, hinging, narrowing and shortening, which may compromise sexual function. Although a variety of non-surgical treatments have been suggested, none to date offer a reliable and effective correction of the penile deformity. As a result, surgery remains the gold standard treatment option, offering the most rapid and reliable treatment which will be the focus of this article. We review the preoperative evaluation, surgical algorithm, graft materials and postoperative management of PD. Outcomes for tunical shortening, tunical lengthening and penile prosthesis placement for penile straightening are reviewed. Tunica albuginea plication is the preferred method of straightening for men with adequate rigidity and less severe disease defined as curvature less than 706 without narrowing/hinging. Men who have more severe, complex deformity, but maintain strong preoperative erectile function should be considered candidates for straightening with plaque incision or partial excision and grafting. Finally, for those men who have inadequate rigidity and PD, penile prosthesis placement with straightening is the best approach to address both problems. Keywords: penile prosthesis; Peyronie's disease, penile reconstruction; plaque excision and grafting; plaque incision; tunica albuginea plication INTRODUCTION Peyronie's disease (PD) is most simply referred to as a fibrotic woundhealing disorder of the tunica albuginea. It is both a physically and psychologically devastating disorder that causes penile deformity, curvature, hinging, narrowing, shortening and painful erections. 1 The perceived loss of length and girth is often more disturbing than the curvature itself, all of which can lead to moderate to severe depressive symptoms, emotional, and relationship problems. 2,3 Despite a myriad of treatment options, PD remains a considerable therapeutic dilemma due to several factors including an incomplete understanding of its etiopathophysiology and the relative paucity of randomized, placebo-controlled trials. A general explanation of this disorder, which has gained acceptance, is that PD is a disorder in which genetically susceptible individuals experience a localized response to endogenous factors such as tumor growth factor-b, which are released in response to microtrauma. This can lead to biological transformation of cells within the tunica albuginea, cell cycle dysregulation, genotypic changes and increased expression of cytokines and free radicals. This inflammatory response leads to unregulated extracellular matrix deposition including fibronectin and collagen, and ultimately plaque scar formation, which does not appear to undergo proper scar remodeling, leaving an inelastic segment in the involved tunica albuginea. [4][5][6][7][8][9] Although a variety of non-surgical treatments have been suggested, none offer a r...

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Section: Tunical Shortening Proceduresmentioning

confidence: 99%

Surgery for Peyronie's disease

Levine¹,

Larsen²

2012

Asian J Androl

110

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“…Currently available surgical options in PD include tunical plication procedures such as the Nesbit wedge resection and the various plication modifications, which are performed on the convex side of the penis. The first reported technique was the Nesbit procedure, which entails excision of a piece of the tunica albuginea on the contralateral side of the curvature [12,13]. Since then, modified Nesbit, Yachia, Essed-Schroeder, Duckett-BaskinLevine, and 16-dot or 24-dot plication techniques have been reported [8,[14][15][16][17].…”

Section: Discussionmentioning

confidence: 99%

164 The Outcome of Multiple Slit on Plaque With Plication Technique for the Treatment of Peyronie’s Disease

Park

Ahn

Kim

et al. 2017

The Journal of Sexual Medicine

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“…8 Reported complications (13%) included urinary retention (one patient), wound infection (®ve), suture granuloma (two), painful knot (one), glans numbness (two), phimosis (two), and haematoma (one). 9 Yachia (1994) reported four cases of loss of sensation Ð one of which was permanent Ð in cases corrected by the Nesbit procedure. 10 Describing experience with different corporoplasty techniques for the correction of congenital penile curvature, the author expressed the opinion that correction of these deformities should be concentrated in the hands of a small group of surgeons in specialized centers.…”

Section: Discussionmentioning

confidence: 99%

Horizontal plication after vertical tunical incisions for the correction of congenital penile curvature

2000

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The objective of this retrospective study is to evaluate the surgical outcome of correction of congenital penile curvature, via multiple vertical incisions in the tunica albuginea that are sutured horizontally using simple inverted 2-0 PDS sutures.The study included 22 men with congenital penile curvature. The surgeries were performed in three general hospitals.The procedures straightened the penile shaft in all cases but a degree of curvature recurred in three cases. No operative or postoperative complications occurred and no reoperations were needed. Four patients complained of penile shortening.We conclude that horizontal plication after vertical corporal incisions is safe and effective in the treatment for congenital penile curvature without hypospadius.

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The Nesbit operation for congenital curvature of the penis

Cited by 39 publications

References 8 publications

Surgery for Peyronie's disease

Surgery for Peyronie's disease

164 The Outcome of Multiple Slit on Plaque With Plication Technique for the Treatment of Peyronie’s Disease

Horizontal plication after vertical tunical incisions for the correction of congenital penile curvature

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