Congenital and acquired penile deviation treated with the Essed plication method

Objectives: To evaluate our results with the Essed procedure for the correc tion of penile curvature, either congenital or due to Peyronie's disease, a nd compare it with the data from the literature, both for the Essed and the Nesbit procedure. Methods: From 1991 to 1996 the Essed procedure was performed in 61 patients . 65.6% (n = 40) had congenital deviation and 34.4% (n = 21) suffered from secondary deviation due to Peyronie's disease. In all patients 2-6 nonabsor bable inverting interrupted sutures were placed bringing the knot between t he plicated tunica. Results: Patients' ages ranged from 15 to 65 (mean 31.3) years and the mean follow-up time was 39.8 (12-75) months. The preoperative penile deviation was between 20 and 90 degrees (mean 47.4 degrees). Eighteen patients (29.5% ) had a recurrent deviation following surgery. This failure rate was higher in the patient group with Peyronie's disease (42.9%) than in the group wit h congenital deformation (22.5%). Postoperatively, 2 patients (3.3%) with P eyronie's disease reported de novo erectile dysfunction. Twenty patients (3 2.8%) complained of persistent discomfort or pain at the area of the still palpable plication sutures, but this inhibited sexual intercourse only in 1 case. 45.9% stated penile shortening after surgery but only 21.3% felt bot hered by this. Conclusion: The results reported are in accordance with the literature show ing a higher recurrence rate of the deviation with the Essed compared to th e Nesbit procedure. For both methods the risk of recurrent disease is highe r in patients with Peyronie's disease and with both techniques, an equally low incidence of erectile dysfunction is evident. However, since with the E ssed technique one third of all patients complained of discomfort from the nonabsorbable sutures, the Nesbit procedure seems to be superior. Copyright (C) 2000 S. Karger AG, Basel.