Sokolakis Ioannis, Schönbauer Petra, Mykoniatis Ioannis, Kübler Hubert, Gschwend Jürgen, Lahme Sven, Hatzichristodoulou Georgios
Department of Urology and Pediatric Urology, Julius-Maximilians-University of Würzburg, Würzburg, Germany.
Department of Urology, Technical University of Munich, Klinikum rechts der Isar, Munich, Germany.
World J Mens Health. 2020 Oct;38(4):564-572. doi: 10.5534/wjmh.190092. Epub 2019 Sep 4.
Congenital penile curvature (CPC) is a rare condition with surgical correction being the standard therapy. In the current study, we report long-term results analyzing the surgical and functional outcomes using a modified Nesbit technique.
Patients with CPC were included. After penile degloving and mobilization of the neurovascular bundle an artificial erection was performed. An ellipsoid part of the tunica albuginea was excised at the point of maximum curvature on the convex side of deviation. The tunical defect was then closed by interrupted absorbable sutures with inverted knots. Results of correction were documented intra- and postoperatively by artificial erection. Pre- and postoperative evaluation included measurement of penile length and curvature after pharmacological erection. Erectile function, alteration in glans sensation, palpable suture as well as short- and long-term complication were also recorded using validated questionnaires and objective examinations.
Fifty-five patients with mean age 26.93 years (14-66 years) and mean curvature 69.81° (25°-90°) were included in the study. Ventral or ventrolateral curvature was observed in 83.6%. Mean operative time was 106.8 minutes (55-169 minutes). Totally straightness of the penis was achieved in 51/55 patients (92.8%). After a mean long-term follow-up of 36.68 months (4-87 months), erectile function worsened in 3.6% of patients. Median penile length loss associated with this technique was 1.7 cm (0-3.0 cm).
Surgical therapy of CPC using our modified Nesbit technique is feasible, safe and provides reliable long-term outcomes, representing an alternative for surgical correction of CPC.
先天性阴茎弯曲（CPC）是一种罕见疾病，手术矫正为标准治疗方法。在本研究中，我们报告了使用改良Nesbit技术分析手术和功能结果的长期结果。
纳入患有CPC的患者。阴茎脱套并游离神经血管束后进行人工勃起。在弯曲凸侧最大弯曲点切除白膜的椭圆形部分。然后用间断可吸收缝线及倒结关闭白膜缺损。术中及术后通过人工勃起记录矫正结果。术前和术后评估包括药物勃起后阴茎长度和弯曲度的测量。还使用经过验证的问卷和客观检查记录勃起功能、龟头感觉改变、可触及的缝线以及短期和长期并发症。
55例患者纳入研究，平均年龄26.93岁（14 - 66岁），平均弯曲度69.81°（25° - 90°）。83.6%观察到腹侧或腹外侧弯曲。平均手术时间为106.8分钟（55 - 169分钟）。51/55例患者（92.8%）实现阴茎完全伸直。平均长期随访36.68个月（4 - 87个月）后，3.6%的患者勃起功能恶化。与该技术相关的阴茎长度中位数损失为1.7 cm（0 - 3.0 cm）。
使用我们改良的Nesbit技术对CPC进行手术治疗是可行、安全的，并能提供可靠的长期结果，是CPC手术矫正的一种替代方法。
