Penile Curvature

The word curvature describes any type of curving  body part. It is common for an erect penis to curve slightly. Penile curvature, however, describes an erect penis with an abrupt curve that can cause pain and interfere with sex. Some men were born with this condition (congenital penile curvature). In others, it develops over time. Penile curvature that develops later in life is called Peyronie’s disease. 

Diagnosis and treatment are similar for congenital  penile curvature and Peyronie’s disease. There is no clear function or angle of curvature that demands treatment. Personal aesthetics, pain, and the inability to have sex are reasons for treatment. Treatment can include: 

  • Watchful waiting 
  • Drug therapy 
  • Surgery 

It is important to determine whether disease is still  active. This will influence medical treatment or timing of a surgery. Disease is considered to be stable when pain has gone away and penile curvature has not increased for at least 3 months. 

What causes penile curvature?

If you were born with penile curvature

Your erect penis has always been bent. Usually the  penis is bent downwards, and this is noticeable as soon a young man becomes sexually mature. Congenital curvature is associated with other problems of the genital organs and is usually recognized during early childhood. 

If you develop penile curvature

You may experience pain in your penis and/or be able  to feel hardening of the tissue as the curve forms. Peyronie’s disease is considered a wound healing disorder. At some point during sex or other activity, the penis has been injured, and the tissues do not heal properly. Excess scar tissue forms in the layer (tunica albuginea) that surrounds the spongy erectile tissue (corpus cavernosa). This causes too much collagen to build up and form fibrous plaque (hard lump) in the penis. Although usually described as rare, both types of penile curvature are likely more common than previously thought. 

The following factors are more common among men with Peyronie's disease than the rest of the population: diabetes, hypertension, high cholesterol or other lipid disorders (FAT), lifestyles, especially smoking and excessive alcohol consumption, erectile dysfunction (erection of low quality makes the penis more prone to bend), narrowing of the arteries that supply blood to the heart, Dupuytren's Contracture, which causes one or more fingers remain tucked in the Palm of your hand, among others.

In Peyronie's disease, it is believed that repeated injuries and trauma cause inflammation in the penis. The tissues that surround the swollen bodies of the penis does not heal properly, causing the formation of a fibrous plate (fibrosis). In the beginning (first phase), can feel pain and nodules under the skin. Over several months, you will notice a penis curvature and the formation of a hard card (second fase). Although the pain subsides and disappears almost entirely, the resulting curvature can cause painful erections and can prevent sexual penetration and intercourse.

Symptoms may include: pain in the penis, tissue hardening of the penis that can be felt through the skin, stiff or painful little erections, decreased libido, low self-esteem and feelings of depression.

In some cases, the curvature and the pain is so intense that it is no longer possible to maintain sexual relations.

After the initial phase, the curvature stabilizes in about two-thirds of patients in the space of several months. In some patients (about 5%), Peyronie's disease disappears without being treated.

Unfortunately, there is no cure for Peyronie's disease, but a number of treatment options. Success can depend on the severity of the problem, age and commitment to the treatment chosen.

Some men with Peyronie's disease (about 13 in 100) develop fibrous plaques in other parts of the body, the most common being the hands and feet. The Dupuytren's Contracture, which causes one or more fingers remain bent on the Palm of the hand, is related to Peyronie's disease. It is not clear what causes the formation of plates or why men with Peyronie's disease are more likely to develop Dupuytren's Contracture.

Treatment with medicines

The treatments with medicines are commonly used in patients for whom the disease without is at an early stage or for patients who are not fit or unwilling to undergo surgery. The goals of treatment with medication include pain reduction, the formation of plaque and the minimization of curvature of the penis. Although many drug options are available, these may not work.

Surgery is reserved for men with severe penile deformities and incapacitating, which make it difficult to have sex. Most health professionals suggest postponing the surgery until the disease has ceased to escalate, and the patient has no pain for at least 3 months. The surgery can correct the curvature of your penis, but implies risks. The type of surgery will depend on your condition. The doctor will take into account:

  • Your personal preference
  • The location of the scar tissue
  • The severity of your symptoms
  • The response to the medication in case of erectile function
  • The length of the penis.

If the medical treatment does not solve erectile dysfunction, your doctor may recommend a penile prosthesis. For men with Peyronie's disease and moderate to severe erectile dysfunction, a vacuum pump or moldable silicone prosthesis placed within the penis will usually straighten it and allow this to stay sufficiently hard for sexual intercourse.

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