Pilot study to determine improvements in subjective penile morphology and personal relationships following a Nesbit plication procedure for men with congenital penile curvature

Aim: To determine whether the surgical straightening of congenital penile curvature can improve intromission comfort, penile features, personal relationships and psychogenic erectile dysfunction (ED). Methods: Fifty‐four patients (mean age 24 years, range 20‐31 years) whose congenital penile deviation due to physiological curvature was ≥ 25 degrees, as measured on a graph, and who were experiencing penetration discomfort were assessed specifically for the present study. Of these, 14 patients suffered from psychogenic ED. The assessment included a case history, an objective examination, a pharmacologically‐induced erection with prostaglandin E1 10‐20 g, a graph taken during erection, a basal and dynamic Duplex ultrasonograph, penile length measurement, nocturnal penile tumescence recording, hormonal profiles and a psychological interview to evaluate the quality of their personal relationships according to Hinde's parameters (contents, number, features, frequency, ability to perceive limits of mutuality, subjective perception of the other person[s], and reliability). All patients underwent the Nesbit procedure. The initial assessment was repeated at 3 and 12 months after surgery. Data analyses were carried out using the z test. Results: Subjective judgement of cosmetic penile features and vaginal intromission comfort improved significantly after surgery whereas the quality of personal relationships and ED did not. Conclusion: The surgical straightening of congenital penile curvature improved intromission comfort and penile features, but it failed to improve interpersonal relationships or psychogenic ED.