Penis curvature – causes, symptoms & therapy

Any deviation from the straight axis of the penis is called penile curvature. This can occur in any direction and does not always have to be pathological, as there are a variety of penis shapes that are considered normal. However, a painful deformity that also causes problems during sexual intercourse requires treatment.

causes

A congenital curvature of the penis already occurs in newborns, and this maldevelopment has genetic causes. For example, the penis tissue can be developed asymmetrically, so that the erectile tissue is shortened or unequal in size. In some cases, the urethra is also shortened, which is called hypospadias.Acquired penile deviation (indivatio penis plastica) can develop either slowly or suddenly. The onset of the disease is usually accompanied by pain during erection, although the causes of this have not yet been fully clarified. It is believed that small injuries to the penile tissue in particular lead to the curvature.

Another cause are changes in the erectile tissue due to hardening. These are caused by so-called plaques (coverings), which can also impair blood circulation. Many patients have similar hardenings on the palms of the hands or on the flexor tendons of the sole. Hardenings in the so-called constriction groove (sulcus coronaris), which separates the glans from the penis, are particularly problematic. If a change occurs in this area, the vascular and nerve cord that runs here is often also affected.

The result is numbness in the glans and erectile dysfunction. The cause of the plaques has not yet been clarified. In many cases, they start out without pain and then turn into a hard scar. There is also an increased risk in men who suffer from diabetes or have a shortened urethra.

When to the doctor?

A slight curvature of the penis is not unusual in itself and usually does not require medical treatment. However, if you experience restrictions in everyday life or during sexual intercourse due to the curvature of the penis, it is advisable to consult a doctor with the symptoms. This prevents complications and long-term effects such as erectile dysfunction.

Pain during erection or in the non-erect state is a first indication that the curvature of the penis should be examined by a doctor. The general practitioner or the urologist are the right contacts here. The curvature of the penis can be treated at any stage. If pain and other symptoms only appear later, going to the doctor is just as useful as at the beginning of the illness.

The reason for a doctor’s visit is not only physical complaints. Not to be underestimated are the psychological problems that can occur in the affected person with a curvature of the penis. Because the subject of curvature of the penis is associated with shame for many men, emotional and psychological pressure can arise on the sufferer. The consequences include social isolation, relationship problems and, in the worst case, even depression . In these cases, a visit to a psychiatrist or a psychotherapist is advisable.

Diseases

Typical diseases with penile curvature:

• Diabetes

• Hypospadie

• Plaques

• Vitamin deficiency / a lack of vitamin E

• autoimmune diseases

• hardening of the arteries

• allergic reaction to beta blockers

symptoms and course

In most cases, the deformation is directed upwards, but hourglass-shaped constrictions can also occur. In most cases, elongated and flat lumps appear on the underside of the penis with a non-congenital curvature of the penis. In this area, the wall of the erectile tissue shrinks and the affected side curves. As a result, erections are very painful or often not possible at all. If the penis is curved more than 60 degrees, there are often difficulties during sexual intercourse. It is also possible for erectile dysfunction to occur, i.e. the penis no longer stiffens sufficiently or not at all.

Diagnose

A penile curvature should always be diagnosed by a urologist. After anamnesis and a physical examination, the erect penis is photographed from three different directions in order to be able to assess subsequent therapeutic success. An erection is usually artificially triggered by an injection into the erectile tissue or with the help of a vacuum pump. During this erection, an ultrasound examination can also be carried out in order to be able to determine the length or size of the pads. Calcifications can also be detected by a partial x-ray. Due to the high X-ray exposure, this type of examination should not be carried out if the patient wishes to have children.

treatment and therapy

In the case of congenital penile derivatives, the doctor must decide whether surgery or correction of the curvature is necessary. Surgery is usually only performed if the patient is suffering from severe pain or if sexual intercourse is significantly restricted as a result. In addition, treatment with medication or injections is also possible.

Special blood pressure medication is injected, which can interrupt the production of collagen precursors. In very mild cases, good results have already been achieved with potassium 4-aminobenzoate. It is important here that the kidney values ​​are checked regularly. Potassium 4-aminobenzoate should not be used in patients suffering from kidney disease .

Various technical procedures (e.g. shock wave therapy or iontophoresis) and mechanical procedures (e.g. stretching apparatus) are also available for treatment. The aim is to alleviate the symptoms and stop further progression of the curvature. However, no method has so far been able to achieve complete regression.If the curvature severely worsens over a period of 12 to 18 months, radiation therapy may also be considered. If there are severe deformations, the only option left is an operation.

Various methods are used here and in the case of a very pronounced dysfunction, the surgeon can also use a penile prosthesis so that the ability to have an erection can be restored. Depending on which method is used, patients must expect a penis shortening or loss of sensitivity.

prevention

A curvature of the penis cannot be specifically prevented. However, one should refrain from sexual practices that lead to a strong bending of the penis in order to avoid possible tissue injuries. In any case, one should also refrain from trying to shape the penis into a different shape, as this can cause serious injuries. Accidents involving the penis should also be treated promptly so that scarring can be prevented.