Surgical correction of penile deviation. Nesbit vs. Schroeder-Essed method

Abstract

60 patients with a marked penile deviation [40 because of a congenital penile deviation (CPD) and 20 as a result of the Peyronie's disease] were questioned about the result of the operation by means of a questionnaire in a retrospective study with an average follow-up of 45 month. The Nesbit procedure had been used with 49 of these 60 patients, the modified Schroeder-Essed technique had been used with 11 patients. There were 15 patients (25%) in all, who suffered a relapse. In spite of the continual use of non-absorbable suture material with the Schroeder-Essed technique, the number of relapses was in this group plainly higher than in the Nesbit group (55% and 18% respectively). In our opinion this is caused by the insufficient tensile strength of pure plications. Regardless of the operating method, patients suffering from IPP showed a higher number of relapses than patients having a CPD (35% and 20% respectively). The reason for this might be the fact that one can never rule out completely the possibility of a further progress of the disease. 71% of the patients in the Nesbit group were satisfied with the results of the operation, in the Schroeder-Essed group there were only 36%. Irrespective of the operating method, IPP patients complained moreoften about late complications and erection problems after the operation and were more rarely satisfied with the result than patients with a CPD (50% and 73% respectively). We put this down to the fact that patients with a CPD and patients suffering from IPP represent very different collectives as far as age structure and morbidity are concerned. IPP patients frequently have erection problems even before the operation. Especially with IPP patients, preoperative erectile disfunction must be excluded, in the case of their occurrence there are to prefer other programmes of therapy.