Научно-клинический центр инновационной медицины
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Nesbit plication — is the most common microsurgical procedure used to correct penile curvature resulting from trauma or to treat Peyronie's disease. Its essence lies in suturing the tunica albuginea of the penis on the side opposite to the curvature. As a result, the organ regains a normal shape, and lost functions, including aesthetic ones, are restored.

Indications for surgical treatment

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Nesbit plication

The tunica albuginea — is an elastic "sheath" composed of several layers of collagen fibers tightly enveloping the cavernous bodies of the penis. This sheath plays a crucial role during erection by ensuring the penis uniformly enlarges and achieves the necessary firmness for sexual intercourse. In cases of injury and microtrauma, excessive growth of connective tissue can occur in the affected area, leading to the formation of areas of fibrosis lacking elasticity. During erection, the cavernous body on the side affected by pathology may not fully fill with blood, resulting in penile curvature.


In this way, among the indications for Nesbit's operation:

● Penile curvature
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● Peyronie's disease
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The operation can only be performed after the patient’s condition has stabilized; therefore, surgical intervention is contraindicated during the acute phase. In this situation, the patient is initially prescribed painkillers.


If the curvature is congenital, plication is often ineffective because it does not address fibrotic lesions but rather inherently deformed cavernous bodies. For these patients, it is more appropriate to consider another procedure — rotation of the cavernous bodies according to Shair.

Benefits of Nesbit plication for treating penile curvature

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Low trauma
Since the operation is classified as microsurgery, it involves a very small incision that heals quickly. Over time, the scar becomes almost invisible.
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High effectiveness
Almost all operated patients report an improvement in the quality of their sexual life and the absence of any problems after the rehabilitation period.
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Quick recovery
Rehabilitation takes only a few months, after which you can return to your normal lifestyle.
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Absence of complications and recurrences
If you follow the recommended guidelines for recovery, the risk of relapse or occurrence of complications (such as erectile dysfunction) is minimal, at less than a fraction of a percent. In our example, there were no such cases.
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Preservation of blood vessels and nerves
With modern optical equipment, there is no risk of damaging nerves or veins.

Stages of the operation

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Stages of the Nesbit procedure
THE LEVEL OF DEFORMATION OF THE PENIS IN AN ERECT STATE IS ASSESSED
A CIRCULAR INCISION OF THE SKIN IS PERFORMED
ON THE CONVEX SIDE OF THE PENIS, TISSUE INCISION IS PERFORMED
CONTROLLED ADMINISTRATION OF THE DRUG IS CARRIED OUT TO ACHIEVE AN ERECTION
SUITS ARE APPLIED

This is achieved through the administration of special medications.

This is done to ensure open access to the tunica albuginea.

The edges of the wound are then sutured.

To assess the effectiveness of the correction.

Sutures are applied to the skin along with an aseptic dressing.

Features of Nesbit plication - important to know

 The surgeon places non-absorbable sutures to restore the organ to its normal shape.

It is important to know!

When choosing treatment for penile curvature using Nesbit plication, it is important to understand that the penis may become slightly shorter due to suturing of the tunica albuginea (approximately 1–1.5 cm in the erect state)

Before signing consent for the intervention, the patient must be informed of this, and plication is only possible if the man is confident that such a result will not adversely affect the quality of his life (including both sex life and psychological state).

If a loss of 1.5 cm in the length of the organ is critical for the patient, the surgeon will suggest another technique - plastic surgery of the tunica albuginea. This is a more complex procedure, but it allows for the preservation of the organ's size.

Frequently Asked Questions

Is it true that after surgery the penis loses sensitivity?
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In what cases is it impossible to perform plication in a straight line?
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The curvature is less than 30°, but it is still associated with severe mental discomfort. Is intervention acceptable?
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What examinations need to be completed before surgery?
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Under what anesthesia is Nesbit plication performed?
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When can I go home?
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When can I resume sexual activity?
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Dr. Oganes E. Dilanyan
Urology-oncology surgeon, Ph.D. of Medical Sciences
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