It is normal for a penis to have a slight bend while erect, if it is not painful and does hinder sexual activity, you do not need to visit a doctor.
Penile curvature
A significant bend that causes pain and makes sexual intercourse painful or hinders it all together is a condition called peyronie’s disease. This disease is marked by the development of fibrous scar tissue “plaque” inside the penis. It is unknown what causes this scar tissue to form but the main theory is that it is due to trauma or bending. Several autoimmune disease and genetic factors may also play a role. The trauma or bending can happen unnoticed, but it causes a bleeding in the penis that causes the formation of scar tissue. The penis is usually bent upwards, but it can be bent downwards to the left, right or a mixture of any of these directions.
Causes of penile curvature
Penile curvature occurs as a result of fibrosis in the white layer surrounding the cavernous bodies, which affects the expansion of this layer during erection and thus instigating the curvature and causing pain.
Penile curvature can be congenital or acquired.
Congenital penile curvature
A congenital penile curvature is when the penile curvature has been there since birth, usually the man can’t remember a time where the penis was straight during erection and it is usually not painful. As mentioned before sometimes genetic factors play a role.
Acquired penile curvature, Peyronie’s disease:
Acquired penile curvature is a curvature of the penis while erect that developed and was noticed by the patient immediately or gradually after trauma. There are cases that might have had trauma but can’t remember it, here it is difficult to differentiate between congenital and acquired penile curvature. Acquired penile curvature is usually accompanied by pain during erection, this pain might get less or disappear over time but the penile bend during erection remains. Acquired penile curvature can also gradually occur in cases of autoimmune diseases that affect the ability of tissues to heal properly.
Curvature of the penis Symptoms
Signs and symptoms of penile curvature may appear suddenly or may develop gradually over time depending on the trauma and genetic factors that contribute to the formation of scar tissue. Plaques of fibrous scar tissue form under the penile skin in an elastic membrane called the tunica albuginea that contributes to keeping the penis stiff during erection. The scar tissue makes the penis less flexible and pulls it in a certain direction resulting in the curvature.
Penile Size
The scar tissue makes the penis less flexible and pulls it in a certain direction resulting in the curvature, this may also make the penis appear shorter.
Pain
The lack of elasticity in the tunica albuginea can cause pain in different levels of severity while the penis is erect.
Penile curvature treatment
Penile curvature usually resolves on its own anywhere between days up to months but if remains the following can be done.
Psychotherapy
Having a penile bend can affect a man psychologically. Especially if it happens in adolescents and young adults, this age group is usually unexperienced and form an image of how their penis should look based on what they see in the media or the male locker room. They usually also do not know the issue can resolve with time. If it starts preoccupying their mind and brings insecurity it might be a good idea to seek a specialist for help. In men with an autoimmune disease that can exacerbate peyronie’s disease this may even be essential.
Lifestyle changes
Avoid trauma to the penis; do not sleep on abdomen, avoid wearing tight clothes, avoid violent or rough intercourse, contract and relax lower pelvic muscles to stimulate blood flow to the penis. Lifestyle changes that might influence penile curvature positively are; quit smoking, reducing alcohol consumption, stop usage of drugs and exercise regularly.
Pharmacological treatment
Several forms of medication can be given to relief symptoms, slow down scar tissue formation or induce clearing it up. Which treatment will be given and in the form of injections or orally depends mainly on the cause of the penile curvature, the extent of pain and how it affects the patients’ quality of life.
Nonmedicinal therapy
- Shockwave therapy, low intensity electroshock waves aimed at decreasing the size of the plaques.
- Vacuum and mechanical traction devices aimed at reducing the penile curve.
- Penile exercises; Simple exercises done alongside any of the above mentioned medicinal and nonmedicinal therapies for 6 weeks. These exercises consist of tightening the penis when not erect, three times a day for 30 seconds per stretch experience spontaneous erections that are not associated with sexual activity for 30 seconds, once a day.
Surgical treatment
If all conservative approaches of therapy have not been successful or improved the patients’ symptoms or quality of life surgery should be considered. Surgical approaches are mainly aimed at removing or reducing scar tissue focusses (plaque) or by restoring the curve by removing tissue on the opposite side. These surgeries are safe and complications due to blood loss are almost nil. However, surgeries could on the long run be the cause of more scar tissue formation, it can also affect the penile size bringing with it more psychological trauma.
Surgeries are only indicated if the pain while erect is unbearable or sexual intercourse is compromised, considerably affecting the quality of the patient’s life.
Bedaya Hospital has a team of andrologists and urologists that will work together to come to the best treatment plan for your penile curvature and the negative effects it has on your life!
