Curved Penis

What is a Curved Penis?

Caring Since 2005 – Men’s Health Clinic Singapore

It is common for many men to have a mild degree of curving in the penis. The curvature could be towards the left or right, and upwards or downwards. Most of the time, the bend is mild and hardly noticeable, but in some men the bend could be up to 90 degrees.

Such severe curvature of the penis could lead to painful erections and affect one’s sexual function significantly. Seeking medical help to get a diagnosis and receive treatment could potentially improve the condition, but many men refrain from seeing a doctor, either due to embarrassment or lack of awareness.

“Why is my penis curved?” The causes for penile curvature are congenital or acquired. Acquired curvature is mainly due to Peyronie’s disease, but can also be due to the healing process of a penile fracture.

Curved Penis

Peyronie’s Disease

Peyronie’s disease is a non-cancerous condition resulting from fibrous plaques of scar tissue developing on the penile tissue.

Peyronie’s disease is reported to affect as many as 1 in 10 men, and is more common between ages 40 to 70, however it can happen in younger men as well. 

Why is my penis curved?

The cause of Peyronie’s disease is not completely understood, however there are several postulated causes and risk factors that could lead to its development:

  • Repeated injury to the penis 
  • Hereditary
  • Age 
  • Underlying medical conditions such as diabetes and connective tissue disease

Symptoms

  • Curvature ranging from mild to severe
  • Scar tissue
  • Painful erections
  • Erectile dysfunction
  • Shortening of the penis

Complications

In severe cases of those who have a curved penis, men may find sexual intercourse to be difficult or impossible due to the pain, the degree of curvature and/or erectile dysfunction. This can result in an inability to conceive with their partner, and also lead to stress on the relationship. The abnormal appearance of the penis and impaired sexual abilities can cause anxiety and diminish a man’s self-confidence.

Treatment

In mild cases of a curved penis, without painful erections or disruption to one’s sex life, there may not be a need for any treatment. The curvature can be observed over time. In many cases, the curvature improves or resolves after a period of 1-2 years. However, if the curvature worsens and causes symptoms, then treatment should be considered. The treatments available include:

  • Extracorporeal Shock Wave Therapy (ESWT). This is a convenient, non-invasive and painless treatment option for Peyronie’s disease. Shock waves are targeted at the location of the fibrous plaque, and helps to break up the scar tissue. 
  • Non-surgical therapy. A number of oral medications have been studied, such as vitamin E supplementation, but results so far have been mixed. There is an FDA-approved injection containing collagenase clostridium histolyticum (Xiaflex), which breaks down the collagen within the fibrous plaque. However, there is a small risk of penile hematoma and penile fracture.
  • Traction therapy. This is indicated only in the early phase of Peyronie’s disease, and involves using a traction mechanical device over a period of time to stretch the penis and correct the deformity.
  • Surgery. There are different surgical options that can be considered based on the severity of the condition and plaque location. Surgery is invasive and carries potential risks such as bleeding, infection, nerve damage and erectile dysfunction. 

Congenital Penile Curvature

Congenital Penile Curvature (CPC) is a relatively uncommon condition. It can be noted early in life by parents during diapering and dressing of their infants. Others do not discover the problem until sexual maturity, where they notice the curvature themselves.

Often, the penile curvature is only observed in the erect state. CPC can sometimes occur together with hypospadias, a urethral abnormality whereby the opening of the urethra is on the underside of the penis instead of the tip. In the absence of urethral abnormalities, the prevalence rate is estimated to be as high as 4-10%. 

Causes

The cause of CPC is not known, but is thought to result from excessive elasticity in one aspect of the penis as compared to the rest of the penis. For example, if there is more tissue elasticity on the top of the penis, it expands more than the rest of the penis during erection, resulting in a downward curve. The curve in CPC is typically downwards.

Symptoms

Like Peyronie’s disease, the curvature ranges from mild to severe. There can be discomfort experienced during sexual intercourse. Men may find that they are only able to have sex in one particular position. Other positions may not be possible due to the nature of the curve. Unlike Peyronie’s disease, CPC does not cause painful erections or erectile dysfunction, and there is no fibrous scar tissue that can be felt. It has the same complications as the Peyronie’s disease.

Treatment

Medical literature suggests that CPC can only be treated surgically. The surgical method used is known as plication, which involves removing tissue and stitching the opposite side of where the curvature is. This method can also be used in Peyronie’s disease. 

There are no evidence-based non-surgical treatments described. However, from our experience at DTAP, we have observed that Extracorporeal Shock Wave Therapy (ESWT) is also able to treat CPC with favourable outcomes. We have treated a considerable number of CPC patients with ESWT alone and achieved either full resolution or significant improvement in curvature. Subjectively, our patients are satisfied. 

Therefore, at DTAP we do offer ESWT as a treatment option for CPC. We would like to re-emphasize that this is not based on the medical literature, but rather from our personal experiences with previous patients. It is always recommended to visit a doctor for a detailed consultation, medical examination and assessment of treatment options before making an informed decision on which treatment to undertake.

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