The Nesbit operation for Peyronie's disease: an analysis of the failures

Abstract

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.

Surgical treatment of Peyronie's disease based on penile length and degree of curvature

“…According to Kelami's 11 classification, severe deviations refer to Z601, so the present study used that value as the selection criterion for surgical technique. After Nesbit's operation, penile shortening is unavoidable, 12,13 as confirmed by the present study. All patients who underwent Nesbit's operation had penile shortening of 2-3 cm, and six of them complained of perceived shortening.…”

A novel modification of tunical plication by plaque thinning: long-term results in treating penile curvature of Peyronie’s disease

“…Briefly, instead of ellipse, a large longitudinal incision or multiple smaller longitudinal incisions were made, and the tunica albuginea was closed horizontally. Although satisfactory results were achieved in several long-term studies with penile straightening rates from 86.3 to 90.5% [4,13,23], however, it also involved some surgical complications and function failures, such as hematoma, infection as well as ED for opening the corpora cavernosa, decreased penile sensitivity or urethral injury due to the mobilization, and penile shortening and recurrent curvature [24].…”

Peyronie’s Disease: Lights and Shadows

“…According to a study done by Ralph et al [44] , based on 359 patients, 295 (82%) patients operated on reported satisfactory results and were able to have intercourse. The main complications of the Nesbit procedure are penile shortening, persisted curvature, and impaired erection [45] . Recurrence of deformity may appear immediately after surgery, as a consequence of a surgical error or suture cutting out or, after some weeks (8-10), probably caused by suture failure.…”