Congenital curvature of the penis

International Classification (ICD)	Q55.-
Symptoms	reduced erectile function, unsatisfactory sexuality, Einschränkungen beim Geschlechtsverkehr, Stress and anxiety during sexual intercourse, vermindertes Selbstwertgefühl, Fertility disorder
Possible causes	Genitourinary disease
Possible risk factors	genetic predisposition
Possible therapies	STAGE technique (surgical intervention), Nesbit technique (surgical procedure)

Basics

Congenital penile curvature, also called congenital penile deviation, describes a deformation of the penis. The medical term is composed of the words "congenital" and "penile deviation". The penis is abnormally curved either downwards, upwards, to the left or to the right. The curvature differs from individual to individual and varies from mild to very severe. Congenital penile curvature affects approximately 0.2 - 1% of the total male population, making it a relatively common medical condition. Unlike acquired penile curvature (induratio penis plastica), congenital penile curvature has existed since birth. In contrast, induration penis plastica develops during adult life.

In most cases, the curvature is not noticed until puberty, when adolescents develop an increased interest in sexuality. The erect penis finally shows that there is a deviation from the central axis. In some affected individuals, the penis is even rotated in the course of the penile curvature.

(iStock / Biserka Stojanovic)

Ursachen

The causes of congenital penile curvature are currently not fully understood. It is assumed that a wide variety of genetic predispositions in combination with environmental factors lead to a defective development of the penis in the embryonic stage. For example, a too short urethra or the formation of scar tissue in the penis can lead to an asymmetric formation of the penile corpus cavernosum during embryonic development.

Symptoms

The major problems associated with congenital penile curvature can be divided into two subgroups:

Functional problem: The more curved the penis, the more difficult penetration is during sexual intercourse.
Psychosexual problem: Bad experiences during sexual intercourse lead young men to avoid intimacy and possibly relationships.

Symptoms that are common in the course of the disease:

Problems during sexual intercourse
Pain during sexual intercourse
Decreased self-esteem
Erection problems
Fertility problems
Anxiety and stress in relationships

Psychosexual problems associated with congenital penile deviation:

Psychological symptoms that may occur in the course of congenital penile deviation include anxiety, lack of self-confidence, and stress. During puberty, affected individuals are also concerned with personality development and healthy sexual development. Penile deviation can vary in severity. Sometimes, due to the curvature, sexual intercourse is no longer possible for those affected, or sexual intercourse causes severe pain for the partner (dyspareunia).

Der männliche Urogenitaltrakt (iStock / peakSTOCK)

The diagnosis is made by a specialized genital surgeon. Here, the problem is addressed in a detailed and sensitive conversation. During the subsequent examination, an artificial erection is induced - by means of an injection into the corpus cavernosum - and the surgeon can examine the curvature of the penis. In addition, a sonographic examination of the penis may be useful before surgical intervention.

Therapy

Currently, there is no helpful conservative treatment method. However, the congenital penile curvature can be operated with the help of the STAGE technique (Superficial Tunica Albuginea Geometrically-based Excision Technique) or also the Nesbit technique.

Das männliche Genital (iStock / activestudio)

STAGE technique

In the STAGE technique, the first step is to determine the maximum point of penile curvature. Here, by means of a small intervention, a maximum straightening of the deviation can be achieved. The corpus cavernosum is not perforated in this surgical technique. Thus, the erectile mechanism of the penis remains untouched. Small ellipses (approximately 3 x 1 mm) are cut out of the outer layer of the corpus cavernosum skin, until the penis is completely straightened, and supplied with absorbable suture material. After the penis is completely straightened, repositioning of all tissue layers and skin is performed.

Nesbit technique

Surgical correction of penile curvature using the Nesbit technique involves shortening the convex (longer) side of the curvature until it matches the concave (shorter) side of the penis. However, this often results in a loss of penile length.

Forecast

With surgical therapy for penile curvature, straightening rates of up to 99% can be achieved. Currently, there are no conservative treatment options available for congenital penile curvature.