Congenital Curvature Correction
What is a Congenital Curvature of the Penis?
A congenital curvature of the penis is a bent of the shaft caused by an asymmetrical development of the corpora cavernosa, which are the chambers that form the penis. In essence, during erections, the asymmetric development of the corpora causes the penis to bend towards the side that has developed less.
Congenital penile curvature is quite like the acquired one, also known as Peyronie’s Disease, as in both cases, the patient complains of a deviation of penis. Although the deviation of the shaft is characterized by a convex (longer) and a concave (shorter) side of the penis in both congenital and acquired penile curvature, in case of congenital penile curvature, the deformity is caused by an uneven development of the corpora cavernosa of the penis. In acquired penile curvature (Peyronie’s Disease), the scarring associated with the plaque causes shortening of one side of the penile shaft (described more below).
Usually, patients notice the presence of a congenital penile curvature when they are adolescent, because at this stage, the chambers of the corpora cavernosa develop at the highest pace.
Fortunately, the majority of congenital curvatures of the penis are minor, and, as a consequence, sexual activity is not affected in most patients. Only a small number of patients present with congenital curvatures so severe they require surgical intervention.
Although with congenital penile curvature the shaft may point virtually in any direction, in the majority of patients, the penis is curved downward (ventral curvature). In general, patients with a dorsal curvature (facing up) are more likely not to experience difficulties during sexual intercourse, as the angle of penetration is directed upward.
Curvatures pointing downwards can be seen in isolation (without any other associated condition) or can be associated with abnormal development of the penile urethra (the waterpipe).
In general, patients with congenital penile curvature seek specialist advice if the curvature makes sex uncomfortable or impossible or if the deformity becomes a cause of embarrassment.
How is it Possible to Distinguish Between Congenital Curvature and Acquired Penile Curvature (Peyronie’s Disease)?
Both congenital and acquired (Peyronie’s Disease) penile curvature can be seen in young men, although Peyronie’s Disease is typically a disease of the fifth decade of life. As a consequence, the age of onset of the curvature is not a reliable criterion to allow the clinician to differentiate between congenital and acquired curvature. In general, in patients with congenital penile curvature, there is no palpable lump or scar tissue, and the curvature is caused by an uneven development of the corpora cavernosa. In acquired penile curvature (Peyronie’s Disease), one or more plaques need to be present.
In general, the majority of congenital penile curvatures are pointing downwards (ventral), while in most patients with acquired penile curvature (Peyronie’s Disease), the penis bends up (dorsal) or laterally (lateral). Narrowing of the corpora (waste deformity or hourglass deformity) is also not found in patients with congenital penile curvature, which tends to be gentler and harmonic than the one of patients with acquired penile curvature (Peyronie’s Disease) where the deformity is mainly localized in the point of the plaque.
Another big difference between patients with congenital and acquired penile curvature (Peyronie’s Disease) is the quality of erections. In general, patients with acquired penile curvature have known cardiovascular disease and experience a degree of erectile dysfunction. There is, instead, no correlation between congenital penile curvature and cardiovascular disease, and this group of patients generally report good quality erections.
How is Congenital Penile Curvature Diagnosed?
The diagnosis of congenital penile curvature is reasonably simple, and it is mainly based on the history and the examination of the genitalia of the patient. The majority of patients with congenital penile curvature notice deformity during adolescence. A thorough examination of the shaft of the penis will confirm the absence of the indurated scars that are the typical indicators of acquired penile curvature (Peyronie’s Disease).
The degree of curvature and the direction of the bend can be assessed only during full erections, when the tunica albuginea of the corpora cavernosa is fully stretched.
Self-photography of the penis in the erect state is not an ideal tool as it can grossly underestimate the degree of curvature. This is because of two main reasons; the first one is that a picture allows assessing the deformity in two planes rather than tridimensionally, while the second one is that if the erection is incomplete, the deformity will appear less marked.
The best way to assess the curvature is during an artificial erection test performed in a clinic after the administration of a vasoactive drug. During the artificial erection, the surgeon is able to adequately assess the curvature in all tridimensional planes.
When suspecting acquired penile curvature (Peyronie’s Disease), if a plaque cannot be palpated, ultrasonography can be extremely useful to identify small plaques and help the surgeon differentiate between the two conditions.
As congenital penile curvature can be associated with anomalies of the penile urethra, it is very important to examine the external urethral meatus and the distal urethra at the time of the assessment.
What are the Options Available for Congenital Penile Curvature Treatment?
The diagnosis of congenital penile curvature is reasonably simple, and it is mainly based on the history and the examination of the genitalia of the patient. The majority of patients with congenital penile curvature notice deformity during adolescence. A thorough examination of the shaft of the penis will confirm the absence of the indurated scars that are the typical indicators of acquired penile curvature (Peyronie’s Disease).
The degree of curvature and the direction of the bend can be assessed only during full erections, when the tunica albuginea of the corpora cavernosa is fully stretched.
Self-photography of the penis in the erect state is not an ideal tool as it can grossly underestimate the degree of curvature. This is because of two main reasons; the first one is that a picture allows assessing the deformity in two planes rather than tridimensionally, while the second one is that if the erection is incomplete, the deformity will appear less marked.
The best way to assess the curvature is during an artificial erection test performed in a clinic after the administration of a vasoactive drug. During the artificial erection, the surgeon is able to adequately assess the curvature in all tridimensional planes.
When suspecting acquired penile curvature (Peyronie’s Disease), if a plaque cannot be palpated, ultrasonography can be extremely useful to identify small plaques and help the surgeon differentiate between the two conditions.
As congenital penile curvature can be associated with anomalies of the penile urethra, it is very important to examine the external urethral meatus and the distal urethra at the time of the assessment.
Am I Suffering from Congenital Curvature of the Penis?
If you have noticed a bend in your penis, which has become more obvious when you were a teenager, it is very likely you have a congenital curvature of the penis.
Most congenital curvatures of the penis are minor and don’t cause any problems during sex. However, if your curvature is significant or it causes you distress, you would benefit from a consultation with an expert in the field. Mr. Garaffa is one of the leading experts in the correction of penile curvatures, and he carries out a large number of straightening procedures every year.
After a thorough examination, which will also involve assessing the degree of your penile curvature during an artificial erection test, Mr. Garaffa will explain to you what the best procedure is to correct the type of curvature of your penis. Straightening procedures are carried out under general anesthesia and as day-case procedures.
Since Mr. Garaffa performs a very large volume of complex congenital penile curvature surgery every year, the operation lasts less than 1 hour, recovery is quick, and you will be able to resume sexual activity with full confidence and a straight penis in 6 weeks.
Contact Mr. Garaffa’s office to learn more about congenital penile curvature surgery cost and what else to expect about the procedure.