The Nesbit Procedure is a surgical intervention designed to correct penile curvature. This operation primarily aims to straighten the penis, addressing a specific anatomical issue that can affect sexual function and quality of life. The procedure involves modifying the penile tissue to achieve a more aligned penile shaft.
Understanding the Condition
The Nesbit Procedure treats Peyronie’s disease, a condition characterized by fibrous scar tissue, or plaque, within the tunica albuginea, the fibrous sheath surrounding the erectile tissue of the penis. This plaque can cause the penis to bend, indent, or shorten during an erection, often leading to pain and making sexual intercourse difficult. Penile shortening is a common symptom. The exact cause of Peyronie’s disease is not always clear, but it is often linked to minor trauma to the penis during sexual activity or other physical stress, which triggers an abnormal healing response.
The Surgical Process
The Nesbit Procedure begins with anesthesia, typically general. The surgeon induces an artificial erection to identify the degree and direction of penile curvature, guiding subsequent surgical corrections. The penis is “degloved,” meaning the skin is pulled back to expose the underlying tunica albuginea.
To correct the curvature, the surgeon focuses on the convex, or longer, side of the penis, which is the side opposite the bend. Small ellipses or wedges of tissue are removed from this side of the tunica albuginea. After removal, the edges are brought together and sutured. This plication shortens the longer side of the penis, thereby straightening the shaft.
Post-Procedure Recovery
Following a Nesbit Procedure, patients experience discomfort, swelling, and bruising in the penile and scrotal areas for a few days. Painkillers are prescribed to manage this post-operative discomfort. Absorbable stitches are commonly used and dissolve on their own. Some patients may have a urinary catheter temporarily inserted for about 24 hours to ensure proper urination.
Most individuals return home the same day or after an overnight hospital stay. Swelling and bruising generally subside within two weeks. Patients are advised to avoid strenuous activities and sexual activity for four to six weeks to allow for proper healing. Adhering to these restrictions helps minimize complications and promotes recovery.
Expected Results and Long-Term Outlook
The Nesbit Procedure generally yields good outcomes in terms of curvature correction, to straighten the penis enough for satisfactory sexual intercourse. Most patients experience a significant reduction in penile curvature, which improves sexual function and overall quality of life. Patient satisfaction rates are generally high due to the functional improvement.
Penile shortening is an inevitable consequence of the Nesbit Procedure, as the technique shortens the longer side of the penis to achieve straightness. This shortening can range from 1 to 3 centimeters, in addition to any length loss already caused by Peyronie’s disease itself. While the aim is to achieve sufficient straightening, some minimal residual curvature may persist. Less common considerations include potential changes in penile sensation or, rarely, a recurrence of the curvature over time.