Nesbit plication
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
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:
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
Stages of the operation
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.
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
Make an appointment with a doctor
AVAILABLE TIME
