15952 Congenital Penile Curvature

Overview

Congenital penile curvature is a curve in the penis that is present from birth. It is sometimes called chordee. The penis may curve downward, upward, or to one side. In many cases, the curve is mild and causes no problems. In other cases, it can make urination or sexual activity difficult.

It is not very common, but it is not extremely rare either. Many men with a slight curve do not even realize they have it.

It affects boys and men. It is usually noticed in childhood, but sometimes it only becomes noticeable during puberty or later.

Symptoms

Common symptoms

• A visible curve of the penis
• Sometimes a lump or band of firm tissue under the skin
• Difficulty aiming the urine stream
• The curve may become more noticeable during an erection

Symptoms in children

• A curve in the penis that may be visible when the child urinates or has an erection
• In some cases, the opening of the penis may be on the underside (hypospadias)

Symptoms in older adults

• The curve usually stays the same, but it can become more noticeable with age
• The curve itself is not painful, but if pain does occur, you should see a doctor

Causes

Main causes

• The exact cause is not fully understood.
• It is thought to happen during fetal development when the tissue that supports the penis does not grow evenly. This creates an imbalance that pulls the penis to one side or downward.

Risk factors

• There is usually no known risk factor.
• It is not caused by anything the mother did during pregnancy.
• It can run in families.

When to see a doctor

See a doctor urgently if:

• If you have a sudden painful erection lasting more than 4 hours, go to the emergency department.
• If you injure your penis and hear a popping sound with severe pain, go to the emergency department.

Book a routine appointment if:

• If the curve causes difficulty urinating, painful erections, or problems with sexual activity, make a doctor's appointment.
• If you are worried about the appearance of your penis, a doctor can reassure you.

Diagnosis

A doctor will ask about your symptoms and examine the penis. The curve is usually visible when the penis is erect, so the doctor may ask you to provide a photo of an erection taken at home, or they may examine you in the office.

Tests that may be done

• There is usually no test needed.
• In some cases, an ultrasound may be used to look at the tissue, especially if a lump is felt.

What to expect at your appointment

The doctor will discuss your options with you. You may be referred to a urologist, a specialist in the urinary and reproductive system.

Treatment

Treatment is only needed if the curve causes problems with urination or sexual activity. Options include observation, devices, and surgery.

Self-care at home

• For a mild curve, no treatment is needed.
• Practise good hygiene and check for any lumps or changes.

Medical treatments

There are no medicines that can fix a curve. In some cases, a vacuum erection device or surgery may be offered. Surgery is the main treatment for a significant curve. The procedure is done by a urologist and involves straightening the penis. This is often done in childhood if the curve interferes with urination or sexual development.

When is surgery considered?

Surgery may be recommended if the curve is severe, causes pain, makes urination difficult, or prevents normal sexual intercourse. It is usually performed when the boy is older or when the man chooses to have it.

Living with this condition

For most men, a slight curve does not affect daily life. If you have surgery, you will need time to heal, but most men are satisfied with the result.

Lifestyle tips

• Stay open with your partner about your condition.
• Use condoms if needed.
• Practise good hygiene.

Diet and exercise

No special diet or exercise is needed for this condition.

Mental health and emotional wellbeing

Some men feel self-conscious about the curve. This is normal. Talking to a counsellor can help if it bothers you.

Prevention

No, it cannot be prevented. It is present from birth. The cause is not related to anything you or your parents did.

Complications

If left untreated

• If the curve is severe and untreated, it may cause difficulty urinating.
• It may cause pain during erection.
• It may cause problems with sexual intercourse.
• It may affect self-esteem.

Long-term outlook

In most cases, congenital penile curvature is harmless. For those who need treatment, surgery is successful in straightening the penis in the vast majority of cases.

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