Penile length loss during Nesbit-type surgery – A prospective study
BAUS ePoster online library. Harrison J. 11/10/20; 304212; P6-3
Ms. Jade Harrison
Ms. Jade Harrison
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Penile length loss during Nesbit-type surgery – A prospective study

Harrison J1, Akiboye D1, Patel P1, Watkin N1
1Epsom And St Helier University Hospitals, United Kingdom

Introduction:
Nesbit's-type procedures (tunical plication+/-excision) for Peyronie's disease curvature shortens the convex side. The BAUS information leaflet states there is 1cm penile length loss (PLL) per 15° curvature correction. In our experience, this PLL seemed excessive. The aim of this study was to determine PLL after correction and whether there were any predictive factors.

Patients and Methods:
A 3-year prospective single centre cohort study included all patients undergoing Nesbit's procedures. Variables recorded included pre and post-operative curvature, pre and post-correction erect length, mode of correction and number of incisions / plications. Data was plotted with line of best fit to determine PLL per degree of curvature correction. Multivariate regression analysis was used to determine causal relationships between PLL and pre-operative factors.

Results:
100 patients underwent surgery. Mean pre-operative curvature was 46° (IQR 34-54°, range 20-91.6°). Mean post-operative curvature was 1.7° (0-5°). Mean PLL was 9mm (IQR 6-10mm, range 0-20mm). Mean PLL per 15° of curvature correction was 3.3mm +/- 1.3mm SD. Multivariate regression analysis revealed that none of the recorded variables (number of plications / degrees of curvature / direction of curvature) were significant factors in affecting PLL.

Conclusion:
PLL during penile curvature correction is significantly less than previous literature and guidelines suggests. There is weak correlation between preoperative degree of curvature and PLL. This may be due to variable plaque densities resulting in variable elastic remodelling during correction. Further analysis is required to ascertain a theoretical model predictor of PLL to enable counselling pre-operatively.
Penile length loss during Nesbit-type surgery – A prospective study

Harrison J1, Akiboye D1, Patel P1, Watkin N1
1Epsom And St Helier University Hospitals, United Kingdom

Introduction:
Nesbit's-type procedures (tunical plication+/-excision) for Peyronie's disease curvature shortens the convex side. The BAUS information leaflet states there is 1cm penile length loss (PLL) per 15° curvature correction. In our experience, this PLL seemed excessive. The aim of this study was to determine PLL after correction and whether there were any predictive factors.

Patients and Methods:
A 3-year prospective single centre cohort study included all patients undergoing Nesbit's procedures. Variables recorded included pre and post-operative curvature, pre and post-correction erect length, mode of correction and number of incisions / plications. Data was plotted with line of best fit to determine PLL per degree of curvature correction. Multivariate regression analysis was used to determine causal relationships between PLL and pre-operative factors.

Results:
100 patients underwent surgery. Mean pre-operative curvature was 46° (IQR 34-54°, range 20-91.6°). Mean post-operative curvature was 1.7° (0-5°). Mean PLL was 9mm (IQR 6-10mm, range 0-20mm). Mean PLL per 15° of curvature correction was 3.3mm +/- 1.3mm SD. Multivariate regression analysis revealed that none of the recorded variables (number of plications / degrees of curvature / direction of curvature) were significant factors in affecting PLL.

Conclusion:
PLL during penile curvature correction is significantly less than previous literature and guidelines suggests. There is weak correlation between preoperative degree of curvature and PLL. This may be due to variable plaque densities resulting in variable elastic remodelling during correction. Further analysis is required to ascertain a theoretical model predictor of PLL to enable counselling pre-operatively.
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