The Nesbitt procedure removes tissue opposite to the curve to straighten the penis.

Penis curvature, congenital or acquired, can often be corrected surgically. We have found the modified Nesbitt procedure to be a relatively simple and safe technique for penis straightening.

This procedure is ideal for men who experience penis curvature. Penis curvature is a very common condition that can be either congenital or acquired. It can occur anywhere along the penis shaft and can deviate in any direction.

In the early stages of the condition there may be some penile pain, especially during erections but this usually settles within the first few weeks or months. The curvature can continue to develop for up to 1 year and surgical treatment is therefore usually deferred until the condition has been present for at least 1 year. Peyronies disease can cause the part of the penis beyond the scar to lose some rigidity during erection (distal flaccidity). Peyronies disease does not usually cause failure of erection although this can also be present. If Peyronie's disease is diagnosed, ask about the treatment options available. If your doctor can't answer your questions, ask for a referral to a consultant with a special interest in male sexual health problems or to a special clinic.

The standard treatment for the curvature is surgery. The commonest operation in the UK is probably Nesbitt's procedure. This involves placing stitches on the opposite side of the penis to the scarring therefore preventing that side of the penis increasing to its full length during an erection and causing the penis to straighten.

The early results are promising but we do not yet know if the improvement in curvature will be maintained in the long term.

This operation does produce some penile shortening (approximately 1mm for every 10° of curvature corrected) and rarely can cause some loss of sensation at the end of the penis.

Peyronie's disease is when a fibrous plaque develops within the shaft of the penis. This plaque will feel like a small hard lump underneath the skin. When erect, the penis bends and looks angular. In some men the bending is so marked that it makes sexual intercourse impossible.

The exact cause of Peyronie's disease is unknown. It's not a sign of an underlying serious condition and it's not a sexually transmitted infection. It's currently thought that some men may have a genetic disposition to the condition.

Any man can develop Peyronie's disease. The average age is 50 for it to develop but it can happen in men as young as 18. About 80,000 men in the UK have the condition.

The three main symptoms of Peyronie's disease are:

• a hard lump (fibrous plaque) within the shaft of the penis
• pain with erections
• bending of the penis when erect

The fibrous plaque causes pain, which can in turn lead to impotence. The penis may bend to the left or to the right, although in most cases it bends upwards. You may not notice the bend immediately as it tends to develop over one to three months. It will usually only be noticeable once the penis is erect.

The cause of Peyronie's disease is not certain but may relate to minor degrees of penile trauma, during sexual intercourse, causing scarring in the body of the penis.

In the early stages of the disease penile pain may be problem although as stated this usually resolves spontaneously and often requires no treatment. Various drugs have been used to try and reduce pain and/or scarring, including Potaba and Tamoxifen, but these are not effective for everyone.

The standard treatment for the curvature is surgery such as the Nesbitt's procedure or other more complex procedures involving excision of the scar and replacement with a graft from elsewhere on the body. A new alternative to surgical treatment is extracorporeal shock wave therapy (see ESWL). A shock wave is focused onto the scarred area, using special equipment and is thought to soften it.