[Surgical correction of penile deviation. Nesbit vs. Schroeder-Essed method].

Area of Science:

• Urology
• Surgical Techniques
• Andrology

Background:

• Penile deviation, including congenital penile deviation (CPD) and Peyronie's disease (PD), affects patient quality of life.
• Surgical correction is often necessary, with various techniques employed.
• Assessing the long-term outcomes and patient satisfaction is crucial for surgical decision-making.

Purpose of the Study:

• To compare the outcomes of the Nesbit procedure and the modified Schroeder-Essed technique for penile deviation.
• To evaluate patient satisfaction and complication rates associated with each surgical method.
• To identify factors influencing surgical success in patients with congenital penile deviation and Peyronie's disease.

Main Methods:

• Retrospective study of 60 patients with penile deviation (40 CPD, 20 PD).
• Patients underwent either the Nesbit procedure (49 patients) or the modified Schroeder-Essed technique (11 patients).
• Outcomes assessed via questionnaire after an average follow-up of 45 months.

Main Results:

• Overall relapse rate was 25% (15 patients).
• The Nesbit group had significantly lower relapse rates (18%) compared to the Schroeder-Essed group (55%).
• Patient satisfaction was higher with the Nesbit procedure (71%) than the Schroeder-Essed technique (36%).
• Patients with PD reported more complications and lower satisfaction than those with CPD.
• Preoperative erectile dysfunction in PD patients requires consideration for alternative therapies.

Conclusions:

• The Nesbit procedure appears more effective and leads to higher patient satisfaction for penile deviation compared to the modified Schroeder-Essed technique.
• Peyronie's disease patients present unique challenges, including higher relapse rates and a greater incidence of postoperative complications.
• Careful patient selection and consideration of preoperative erectile function are essential, particularly for patients with Peyronie's disease.