Dr Kühhas Talks About the Curvature of the Penis


Curved penis from birth

Congenital curvature of the penis is relatively rare. And even if a congenital curvature – as the name suggests – is congenital, many sufferers only notice in puberty that something is wrong with their penis.

The congenital curvature results from an abnormal development in the uterus. If the urethra does not develop properly in the embryo or if the connective tissue does not unfold properly, the erectile tissue also develops unevenly, which later leads to a crooked erection.

When the penis curves with age.

Acquired curvature of the penis, medical Induratio Penis Plastica (IPP), affects significantly more men. There are no exact figures here either, but it is assumed that around 10% of all men will suffer from an acquired curvature of the penis in the course of their lives. Most of the patients are 40 years or older, but younger men are also affected again and again.

With IPP, the erection can no longer develop properly because a kind of scar tissue forms on the shaft of the penis plaque – forms. During an erection, the cavernous bodies can no longer swell evenly, and the penis then curves significantly, often literally kinks or there are indentations on the shaft. The penis often becomes shorter as the disease progresses, and in the advanced stage, there is a risk of erectile dysfunction.

The phases of the IPP

The IPP typically proceeds in two phases. In the first, “acute” phase of the disease, the plaque forms, and the erect penis begins to change. In addition, about half of those affected experience severe pain in the limb.

At some point, the IPP will go into the “chronic” phase above. The curvature of the penis is then stable, which means that it no longer gets worse and there is no pain either.

The division into acute and chronic phases is made because the treatment options differ.

The causes of penile curvature

The causes of acquired penile curvature are not yet entirely clear. Research is currently assuming a genetic predisposition, which means that the body overreacts to the smallest injuries to the penis, which happen, for example, during sex, and therefore scar tissue forms. This plaque is perceived by affected men as a nodule and leads to the classic symptoms due to the change in the elasticity of the erectile tissue.

Treatment of penile curvature

The treatment options depend on the type of curvature. Unfortunately, congenital curvature of the penis can only be treated surgically so far. The treatment of IPP, on the other hand, depends primarily on the stage of the disease.

Conservative treatment methods

In the acute phase, acquired penile curvature can only be treated conservatively. In injection therapies, for example, a drug is injected into the penis to dissolve or at least loosen up the plaque. PDE5 inhibitors are also used as part of drug treatment.
Penis extenders and vacuum pumps are then used in combination to stretch the tissue. Shock wave therapy can also help against the pain in the acute phase of IPP.

Surgical treatment methods

If conservative treatments do not work, surgery must be considered in the chronic phase of the disease. There are different techniques here. In the classic method (NESBIT), the long side of the penis not affected by plaque is gathered so that it is just as short as the affected side. This inevitably makes the penis shorter. To prevent this, there are also alternative approaches (grafts) that try to split up the plaque and insert artificial filling material, which is then gradually replaced by the body’s own cells.

penile curvature and erection problems

Erectile dysfunction often occurs in very advanced stages of IPP. If this is the case, even a simple penis straightening will not correct the problem. In such cases, an erectile tissue replacement (penile prosthesis) must also be implanted.

When to the doctor?

In some cases, even a pronounced curvature of the penis is not associated with any restrictions for the man concerned, in other cases even a slight degree of curvature can lead to problems in sex life and reduced self-esteem.

It is therefore difficult to give a general recommendation as to when a crooked penis needs to be treated. As with any other disease, you should contact a doctor early on in the case of penile curvature to have the problem clarified.

It is assumed that the number of unreported cases of penis curvature is relatively large because affected men often do not know what to do or do not dare to go to the doctor. When patients feel the plaque for the first time, the fear of having cancer is often involved. This fear can be taken away by a visit to a specialist.

The earlier a penis curvature is treated, the better the chances of improvement.

profile picture dr medical Franklin E. Kuhhas
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About the author – Dr. medical Franklin E. Kuhhas

dr medical Franklin E. Kuehhas is a specialist in urology and andrology and one of the few doctors worldwide with special training in reconstructive andrology with a focus on male genital surgery. In his practice in Vienna, Dr. Kuehhas the small and the big problems of the man. Website: https://www.dr-kuehhas.at/

The explanations and lists of possible treatment options are purely informative and do not replace consultation with your doctor or the explanations about the intake, mode of action and side effects from the product-specific leaflet.

Isabel D White

Isabel D White

Isabel led the Royal Marsden Hospital (London) psychosexual therapy service until 2019. She works in partnership with individuals & couples to explore physical, emotional & relationship factors that contribute to sexual difficulties after cancer. These include: low desire, erection, arousal or orgasmic difficulties, sexual pain & sexual avoidance. She adopts an integrative approach to personalized therapy using psychosexual therapy (sensate focus framework), biomedical management (erectile dysfunction medication & devices, menopause & vaginal health strategies, sexual aids) & psychoeducation.

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