Long-term results in congenital penile curvature diseases treated with Nesbit method

Yıl 2019, Cilt: 44 Sayı: 2, 388 - 394, 30.06.2019

Umut Ünal , Hakan Erçil Erbay Tümer , Ergun Alma , Güçlü Gürlen Nevzat Can Şener Zafer Gökhan Gürbüz Yalçın Evliyaoğlu

https://doi.org/10.17826/cumj.443754

Cited By: 1

Öz

Purpose: In this study, we aimed to report the long-term results of congenital penile curvature (CPC) patients treated by a single surgical team using the Nesbit procedure.

Materials and Methods: Forty patients who underwent Nesbit procedure due to CPC in our clinic were retrospectively reviewed. Penile curvature sites of patients were classified as ventral, dorsal, lateral and biplanar. Penile length, curvature and location of the patients were recorded with perioperative measurements and this value was based on patient follow-up. The patients had penile length, residual curvature condition after intracavernal papaverine injection at 12 months postoperatively. At the same time, the International Index of Erectile Function-5 (IIEF-5) was questioned and its subjective complaints and satisfaction were evaluated.

Results: The mean age of the patients was 26.8 years (18-42). The mean preoperative curvature was 55.6 (40-90) degrees. The mean follow-up was 39.9 (12-97) months. The number of patients with postoperative complete axial regularity was 22 (55%). 17 (42.5%) patients had an average clinically insignificant residual curvature of 13.2 degrees (10-30). One (2.5%) patients had residual (40 degree) curvature. None of the patients had perioperative and early postoperative complications.

Conclusion: Curvature grade and location, penis size and erectile capacities in CPC patients are among the factors affecting surgical technique selection. At least the experience of the surgeon as much as these variables influences the choice of the surgeon. Nesbit is a successful method in the appropriate patient group with CPC with longterm outcomes.

Anahtar Kelimeler

NESBIT method

Nesbit yöntemi ile tedavi edilen konjenital penil kurvatür hastalarında uzun dönem sonuçları

Öz

Amaç: Bu çalışmada tek cerrahi ekip tarafından Nesbit prosedürü uygulanan konjenital penil kurvatür (KPK) hastalarının uzun dönem sonuçlarını yayınlamayı amaçlanmıştır.

Gereç ve Yöntem: KPK sebebiyle Nesbit prosedürü uygulanan 40 hasta dosyası retrospektif olarak incelendi. Hastaların penil kurvatür yerleri ventral, dorsal, lateral ve biplanar olarak sınıflandırılmıştı. Hastaların penis uzunluğu, eğrilik derecesi ve yeri perioperatif ölçümlerle kayıt altına alınıp hasta takibinde bu değer esas alınmıştı. Hastalar postoperatif 12. ayda intrakavernal papaverin enjeksiyonu sonrası penis boyu, rezidüel kurvatür durumu kayıt altına alınmıştı. Aynı zamanda Uluslararası Erektil İşlev Formu -5 (IIEF-5) sorgulanıp, sübjektif şikâyetleri ve memnuniyetleri değerlendirildi 

Bulgular: Hastaların ortalama yaşı 26.8 (18-42) yıl idi. Preoperatif ortalama kurvatür derecesi 55.6 (40-90) derece idi. Ortalama takip süresi 39.9 (12-97) aydı. Postoperatif rezidüel kurvatürü olmayan hasta sayısı 22 (%55) idi. 17 (%42.5) hastanın ortalama 13.2 derece (10-30) klinik önemsiz rezidüel kurvatürü mevcuttu. Bir (%2.5) hastanın rezidüel (40 derece) kurvatürü mevcuttu. Hastaların hiçbirinde perioperatif ve erken postoperatif komplikasyon görülmedi.

Sonuç: KPK hastalarında kurvatür derecesi ve yeri, penis boyutları ve erektil kapasiteleri cerrahi teknik seçimini etkileyen faktörler arasındadırlar. En az bu değişkenler kadar cerrahın tecrübeli olduğu teknikte cerrahın seçimini etkiler. Uzun dönem sonuçlarıyla KPK’ü olan uygun hasta grubunda Nesbit başarılı yöntemdir.

Anahtar Kelimeler

nespit, konjenital penil kurvatür

Kaynakça

• 1.P Vicini1, S Di Nicola1, G Antonini2, E De Berardinis2, V Gentile2 and F De Marco1 International Journal of Impotence Research (2016) 00, 1–7 © 2016 Macmillan Publishers Limited, part of Springer Nature. All rights reserved 0955-9930/16
• 2.Schwarzer U, Sommer F, Klotz T, et al: The prevalence of Peyronie’s disease: results of a large survey. BJU Int 88: 727–730, 2001
• 3. Yachia D, Beyar M, Aridogan IA, et al. The incidence of congenital penile curvature. J Urol. 1993;150:1478-9
• 4. Ebbehoj J, Metz P. Congenital penile angulation. Br J Urol. 1987;60:264–6
• 5. Kelami, A.:Congenital penile deviation and its treatment with the Nesbit-Kelami technique. Br J Urol, 60: 261, 1987
• 6.Congenital Penile Curvature: Update and Management Iryna Makovey&Ty T. Higuchi&Drogo K. Montague&Kenneth W. Angermeier&Hadley M. Wood Curr Urol Rep (2012) 13:290–297
• 7. Brake M, Keller H, Lamade F, Groh R, Horsch R. Operative Korrektur der Penis deviation [Surgical correction of penile deviation. Nesbit vs. Schroeder-Essed method]. Urologe A. 1999;38(3):264-9.
• 8. Sassine AM, Wespes E, Schulman CC. Modified corporoplasty for penile curvature: 10 years' experience. Urology. 1994;44(3):419-21.
• 9. Nesbit, R. M.:Congenital curvature of the phallus: report of three cases with description of corrective operation. J Urol, 93: 230, 1965
• 10. Nyirady P, Kelemen Z, Banfi G, et al. Management of congenital penilecurvature. J Urol. 2008;179:1495–8.
• 11. Hsieh JT, Liu SP, Chen Y, et al. Correction of congenital penile curvature using modified tunical plication with absorbable sutures: The long-term outcome and patient satisfaction. EurUrol. 2007; 52:261–6.
• 12. Popken G, Wetterauer U, Schultze-Seemann W, et al. A modified Corporoplasty for treating congenital penile curvature and reducing the incidence of palpable indurations. BJU Int. 1999;83:71–5.
• 13. Leonardo C, De Nunzio C, Michetti P et al: Plication corporoplasty versus Nesbit operation for the correction of congenital penile curvature. A long-term follow-up. Int Urol Nephrol 2012; 44: 55–60.
• 14. Poulsen J, Kirkeby HJ. Treatment of penile curvature–a retrospective study of 175 patients operated with plication of the tunica albuginea or with the Nesbit procedure. Br J Urol. 1995;75:370–4.
• 15. Giammusso B, Burrello M, Branchina A, et al. Modified corporoplasty for ventral penile curvature: description of the technique and initial results. J Urol. 2004;171:1209–11.
• 16. Daitch JA, Angermeier KW, Montague DK. Modified corporoplasty for penile curvature: long-term results and patient satisfaction. J Urol. 1999;162:2006–9.
• 17. Ghanem H, Ghazy S, El-Meliegy A. Horizontal plication after vertical tunical incisions for the correction of congenital penile curvature. Int J ImpotRes. 2000;12:117–9.
• 18. Ghanem H, Shamloul RM. Incisional corporoplasty for the correction of congenital penile curvature: a review of two suturing techniques. Int J ImpotRes. 2008;20:222–5.
• 19. Chien GW, Aboseif SR. Corporeal plication for the treatment of congenital penile curvature. J Urol. 2003;169:599–602.
• 20. Hauck EW, Bschleipfer T, Diemer T, et al. Long-term results of Essed-Schroeder plication by the use of non-absorbable Goretex sutures for correcting congenital penile curvature. Int J ImpotRes. 2002;14:146–50.
• 21. Lee SS, Meng E, Chuang FP, et al. Congenital penile curvature: long-term results of operative treatment using the plication procedure. Asian J Androl. 2004;6:273–6.
• 22. Nooter RI, Bosch JL, Schroder FH. Peyronie’s disease and congenital penile curvature: long-term results of operative treatment with the plication procedure. Br J Urol. 1994;74:497–500.
• 23. Van Der Horst C, MartinezPortillo FJ, Seif C, et al. Treatment of penile curvature with Essed-Schroder tunical plication: aspects of quality of life from the patients’ perspective. BJU Int. 2004;93:105–8.
• 24. Hsieh JT, Huang HE, Chen J, et al. Modified plication of the tunica albuginea in treating congenital penile curvature. BJU Int. 2001;88:236–40.
• 25. Simonato A, Gregori A, Ambruosi C, et al. Congenital penile curvature: dermal grafting procedure to prevent penile shortening in adults. EurUrol. 2007;51:1420–7. discussion 1427-8.
• 26. Badawy H, Morsi H. Long-term follow up of dermal grafts for repair of severe penile curvature. J Urol. 2008;180:1842–5.