Pilot study to determine improvements in subjective penile morphology and personal relationships following a Nesbit plication procedure for men with congenital penile curvature

Abstract

To determine whether the surgical straightening of congenital penile curvature can improve intromission comfort, penile features, personal relationships and psychogenic erectile dysfunction (ED). Fifty-four patients (mean age 24 years, range 20-31 years) whose congenital penile deviation due to physiological curvature was>or=25 degrees, as measured on a graph, and who were experiencing penetration discomfort were assessed specifically for the present study. Of these, 14 patients suffered from psychogenic ED. The assessment included a case history, an objective examination, a pharmacologically-induced erection with prostaglandin E1 10-20 g, a graph taken during erection, a basal and dynamic Duplex ultrasonograph, penile length measurement, nocturnal penile tumescence recording, hormonal profiles and a psychological interview to evaluate the quality of their personal relationships according to Hinde's parameters (contents, number, features, frequency, ability to perceive limits of mutuality, subjective perception of the other person[s], and reliability). All patients underwent the Nesbit procedure. The initial assessment was repeated at 3 and 12 months after surgery. Data analyses were carried out using the z test. Subjective judgement of cosmetic penile features and vaginal intromission comfort improved significantly after surgery whereas the quality of personal relationships and ED did not. The surgical straightening of congenital penile curvature improved intromission comfort and penile features, but it failed to improve interpersonal relationships or psychogenic ED.