MODIFIED NESBIT PROCEDURE FOR THE TREATMENT OF PEYRONIES-DISEASE - A COMPARATIVE OUTCOME ANALYSIS

Purpose: We describe a surgical modification of the Nesbit procedure t o correct Peyronie's disease, and compare the results of this procedur e with those of 2 other surgical techniques. Materials and Methods: In 30 patients a vertical incision in the tunica albuginea was closed in a horizontal fashion with permanent suture knots buried beneath the t unica in a running looped fashion, resulting in watertight closure wit h no exposed suture material. A standard Nesbit procedure and plaque e xcision with a polyethylene terephthalate mesh reinforced silicone she et patch graft were done in 28 cases each. Results: Elimination of pen ile curvature, patient satisfaction and postoperative impotence rates were not statistically different for standard and modified Nesbit proc edures. However, plaque excision and synthetic patch grafting resulted in less elimination of curvature (61%, p = 0.004), a lower rate of sa tisfaction (30%, p = 0.00002) and a higher incidence of impotence afte r surgery (18%, p = 0.04). The modified Nesbit procedure achieved an o verall higher rate of correction of curvature than the standard approa ch (93 versus 79%). Conclusions: A modified Nesbit procedure achieves the greatest functional success for Peyronie's disease with an accepta bly low complication rate.