Video
Voiceover:
For the last year, Keith has been living with a curvature of his penis that occurs whenever he gets an erection.
Keith:
Can’t have sex now. It makes me a bit…inadequate.
Voiceover:
He’s come to Russells Hall Hospital to meet consultant urological surgeon Mr Paul Anderson. Because Keith’s condition only presents itself when the penis is erect, he’s given an injection to induce an erection, so that the extent of the curvature can be fully assessed.
Mr Anderson:
I’m looking at how curved it is, and I’m looking at how long it is, and I’m looking to see if the foreskin’s going to cause any problems…and you really have got an S-shaped curvature.
Voiceover:
Keith has two options for surgery…
Mr Anderson:
There is the shortening option. What we would do is we would make two incisions and remove some tissue from here, close that area up, so you are going to lose length with this operation, but there’s a very low risk of erectile dysfunction with this. An alternative would be to think about a grafting procedure, but rather than operating on the good side, we’d concentrate our efforts on the bad side, and I would open it up, and there would be a defect just there. And into that defect, I would place a graft. And this is often a graft taken from a vein from the top of your legs. It is a good option, but the problem is it does carry a much higher rate of impotence, problems with erections, afterwards.
Voiceover:
Keith’s got a tough decision to make: risk impotence or lose length.
Keith:
I’ve, uh, took the option of shortening, cutting the penis on one side to pull it over to the right. It might shorten it two or three centimetres, but that would be okay.
Voiceover:
It’s the day of Keith’s operation. He’s undergoing the Nesbitt’s procedure, where he will lose some length, but the risk of impotence is low.
Mr Anderson:
Now, he’s got a fairly healthy-looking foreskin, and we spoke about whether we should get rid of the foreskin or not, and he decided he wants to keep it. About one in ten men need a circumcision later. The first thing I need to do, really, is just get all the skin off here, and start to have a look at the problem underneath the skin.
Voiceover:
Mr Anderson makes a small incision just under the head of the penis, and then pulls back the skin.
Mr Anderson:
Right, this is the bit where we skin the penis. It comes off quite nicely, typically. And all these structures that you can see here, these are the nerves and arteries and some of the veins that we’ll be so careful to avoid during the operation. So the curvature will be all around the plaque there, so the correction that we want to do will be all along the opposite side of the penis.
Voiceover:
A tourniquet is placed around the base of the penis, so that an erection can be induced with saline solution.
Mr Anderson:
Okay, so now we’re going to induce an artificial erection. And we shall see how bad this curvature is. Now you can see here how curved he is, you can see that he’s straight to about that point there, so nothing needs to be done between there and there. So all the work is going to be done between here and here.
Voiceover:
It’s a delicate procedure as all of the nerve structures on the side of the penis need to be moved out of the way.
Mr Anderson:
All this tissue here contains all his nerves that supply sensation to his glans there, and I need to continue working in this plane here to get it out of the way, so I can operate on the white area.
Voiceover:
Mr Anderson uses clamps on the good side of the penis to work out where the incisions need to be made to correct the curvature.
Mr Anderson:
You can see that now I’ve got three corrections down the right side, to uh, to straighten his penis. But if you now come and have a look around at this side here, I’ve had to fully mobilise his new vascular bundle past the midline at the back, to put in a further correction. So now he’s got a slight…no, now this is straight, but there’s a slight curve upwards, but some men…and women…would regard that as an advantageous thing. So a slight degree of dorsal curvature is a good thing to have in a penis. Right, so the next step of the operation is for me to remove small defects within this corporal tissue and sew him up again.
Voiceover:
Two hours later, and Keith’s wonky willy is no longer.
Mr Anderson:
I think you’ll agree that he’s a lot, lot, lot straighter now. That won’t cause any problems whatsoever with uh, vaginal intercourse. Put the skin back up there again.
Voiceover:
Mr Anderson stitches and bandages Keith back up, and a catheter is put in place overnight.
Voiceover:
A few weeks after the surgery, and Keith is back to update Dr Christian on his progress.
Dr Christian:
So how long has it been since the operation?
Keith:
It’s been six weeks tomorrow.
Dr Christian:
Okay, and how are you feeling?
Keith:
Oh, I’m feeling all right, back more or less to normal now, and it’s uh, it’s straight.
Dr Christian:
Have you used it yet?
Keith:
No, I haven’t.
Dr Christian:
You haven’t, you’re too scared.
Keith:
It’s still a virgin.
Dr Christian:
And are you peeing okay?
Keith:
Oh yeah, but instead of going straight into the pot, it comes out three different places, because there’s too much skin.
Dr Christian:
Because you’ve lost the length…
Keith:
Because I’ve lost an inch, I’ve got a lot of skin now.
Dr Christian:
I’d like to have a quick look, check that it has healed properly, and also maybe have a look at this foreskin issue, see what we can do about that if we need to, yeah? Come over to the couch with me.
Dr Christian:
Proud owner of a new willy.
Keith:
Yup, a new willy, no?
Dr Christian:
That’s a little bit of bumpiness in the middle, isn’t there?
Keith:
Yeah.
Dr Christian:
That’s going to settle. You are new…is it very sore or not too bad?
Keith:
No, no, not at all, it’s not sore now at all. It’s just it won’t come out there, that’s as far as it comes out, a bit tight, yeah?
Dr Christian:
Yeah. Well, because you’ve got all this tethering, all the skin is still a little bit stuck to the shaft. You need to leave this well alone for a little while, let it all heal. Eventually when the scarring settles down, things will loosen up a bit as well. The more you get erections, the more that’ll just help the skin to loosen up and shift around a bit. And only a good three, four months down the line do you then start to think ‘do I have too much foreskin, will I need a circumcision as well, because it’s affecting the way I pee’. But otherwise, are you pleased?
Keith:
Oh yeah, happy as a lark.
Dr Christian:
I think it’s a great result, so I’m pleased.
Keith:
I am too.
Dr Christian diagnoses Peyronie’s disease when Ambulance technician Keith comes to the clinic. Realising the severity of this particular case Dr Christian sees surgery as the only option, and refers Keith on to a urological surgeon who he hopes can straighten things out. Keith meets consultant urological surgeon Mr. Paul Anderson to discuss options. With advice from his surgeon Keith opts for a Nesbitt’s procedure which removes tissue from the unaffected side of the penis so that things balance out when sewn back up, even if slightly shorter. After a two-hour procedure Keith’s penis is corrected, with Dr Christian recommending that he waits a few months before seeking further treatment for his excess foreskin.
Patient Name: Keith Roberts
Condition: Peyronie’s Disease
Specialist: Mr. Paul Anderson, Consultant Urological Surgeon
Hospital: Russells Hall Hospital, Dudley
Length of operation: Approx 2 hours
Yes
NoComments and Questions
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I had Nesbits two weeks ago and everything is fine except that I wake up a number of times each night with an erection which hurts like hell. I guess it's pulling on the stitches? Has anyone else experienced this problem and, if so, how long did it go on? I need a good nights sleep!
i have peyronie's and i'm in my sixties.Should i have the operation? I stillhave great erctions
Hi just had the surgery done 9 days ago and feeling fine a little discomfort but nothing to painful I went back to work after 3 days I was a little worried when I started getting erections so looking forward to trying it out as intercourse has been zero I have spoken openly with my problem and found 3 other guys with the same problem but they were afraid to discuss it with anyone But anyone with the problem get the operation it's not that bad had the op Friday and walking around the shops Saturday morning with my wife Don't worry about the pills and ointments just have the operation Regards John
hi jon, damaged my willie during intercourse have all the feeling but no erection it bends a little to the left happened about 18 months ago im 61 and healthy love my wife who i fancy to death have been using a rubber ring which helps a little but latly it dosnt seem to work would be interested to see how you get on
I am in the same situation. Going for my third shot of veramil. The first two don't seem to have helped at all. I am worried I will have to have the surgery. How are you at this stage after the surgery? Thank you for your insight.
Please help me with peyronies my partner names calls me and i feel bad
I have had peyronies for over three years, and have lost over 3 inches in length. If I have the AMS 700 implant will I regain any of my length back. Also will I have feeling in the penis?
I am on day 2 post nesbitt op and still a little sore. Still swollen but I seem to have lost about 2cm. Took about a year to sort out with the NHS (I posted here on 8/11/11) but my original surgeon retired and we changed doctors.... long story!. First class treatment post op from our local NHS hospital. Hopefully everything will work ok when its healed up but thanks to Channel 4 for the program and the video. Up to now no regrets whatsoever!
is the operation better if a person is already circumsized?
Has anyone had the Lue procedure or any other that doesnt shorten the penis & if so plse inform about results. Tnx
I was diagnosed with peyronie's about 2 years ago. I'm thinking of having surgery but since I have never been circumcised I would like to stay that way! I believe with the Nesbit's procedure it is mostly done with de-gloving of the penis which requires circumcision.I think it is bad enough to have the disease and to have to go through surgery without the added insult/pain of circumcision. I think David Ralph has published a paper on peyronie's surgery which does not require circumcision. Any helpful suggestions appreciated
i would have thought that circumcision which disrupts the vascular system which carries blood around the penis was the worst possible thing to have done as good blood circulation is the key to good erections , also it removes up to 2/3 of the penile nerves many of which are in the foreskin and adjacent areas, also after the nesbit guys say there penis is shorter is this because they have lost skin length by being circumcised ? the guy on the c4 programme when flaccid after the op only had the glans showing no shaft at all ,not good ,i hope a non circumcision procedure exists as that would be my choice . maybe the sleeve de-gloving can be done just below the foreskin base ,
I`m 13 and i have Peyronie's disease and can i have sugery on it at this age.
I got it at 17, and again at 19, after reading everything in the medical library at University, I tried and exclusion diet, for me the iussue was cheese and wine, I gave them up Pain went, I no longer needed drugs and over months the penis straigtened. If I look close the original lump is still there and if I do cheese it sometimes is painful. However, I am 51 and have not required drugs or aan operation. The only medical lityerature I found at Uni said some evidence that peronies disease could be associiated with wounds or poisoning. It was no more than a guess to test for food intolerance / allergy and I am not aware of any studies that support my findings, But what have you got to lose by trying an exclusion diet? If the diet is going to work, you should know within the first few days by a significant reduction in pain.