May 23, 2014
Some bending or curvature of the erect or flaccid penis is very common and hardly deserving of the status of “a condition”. About 50% of all men will have some slight bending or curvature of their penis at some stage or other of their lives. This should not be viewed as a problem nor should the man be made self-conscious about it.
Curvatures or bending; and I use both terms synonymously, may be “lateral” that is pointing to left or right. Or it may be “ventral” -- that is bending downwards or forwards, or dorsal – that is bent upwards or backwards towards the body. Or a penile curvature may be a combination of all four directions depending on where the internal constrictions occur.
Anatomy of an Erection. Down the entire length of the penis run three spongy chambers or cylinders. To achieve an erection these spongy chambers must fill up with blood and become engorged. Running along each side of the penis we have two chambers called the Corporus Cavernosa while running along the under side there is a single chamber called the Corporus Spongiosum. All chambers are interconnected. Lining the outside of each of these spongy cylinders is an elastic stretchable membrane called the Tunica Albuginea. This is where the trouble occurs.
In order for an erect penis to be arrow straight it is necessary for all three chambers to fill up with the exact same amount of blood, under the same amount of pressure and to be held there by three separate Tunica Albuginea of exactly equal elasticity. When you think of it this way then is it hardly surprising that perfect geometrical symmetry is not always achievable?
Causes of Penile Curvature or bending. There are mainly three causes for curvature of the erect penis. These are:
(1) Congenital. This is the common situation where a man is borne with some asymmetry in the manner in which his erections develop. Typically, this situation, that lasts for a lifetime, does not progress. Or if it does progress it does so very slowly.
(2) Traumatic. This is a curvature on the penis caused by some trauma to the Tunica Albuginea leading to the deposition of some fibrous non-stretchy scar tissue in that area of damage. The bend will be away from that lesion. Causes of such trauma could be the too frequent use of penile injection as a treatment for erectile dysfunction. Or another common cause might be a part-fracture of the tunica arising from some accident during sexual activity. In the majority of cases these fibrous plaques can be felt by an experience4d examiner or by the man himself.
(3) Peyronies Disease. This term is sometimes used as a generic for all penile curvatures. That is incorrect. Peyronies Disease is a separate entity. Again, as with ALL penile curvatures the fault lies with the tunica where, for reasons not understood, there is a deposition of fibrous tissue preventing the symmetrical expansion of one or more of the spongy chambers or cylinders. Peyronies Disease may or may not be progressive.
Treatments for Penile Curvature. Here is where you need to exercise extreme caution indeed. Particularly with the advent of the Internet, this whole area has become shark infested waters. Do a Google search on Penile Curvature and it will throw up pages upon pages for money back guaranteed ways to straighten out you bent penis. But do any of them work?
I claim no expertise in this area but I have just spent the last four hours scouring the Internet on this subject on your behalf. All my instincts as a doctor tell me that none of these expanders, or stretchers, or splints, or exercises, medicines or even injections do or can do anything at all for a penile curvature. However, I am not just informed by instincts. Two additional factors lead me to this conclusion.
(a) We have already seem that at least 95% of all penile curvature is caused by the laying down of fibrous plaque or scar tissue on the tunica Albuginea. Common sense if nothing else would seem to indicate that scar tissue is not simply dislodged by stretching or pulling. Indeed if anything it can be made worse by such futile endeavours.
(b) If any of these things worked to straighten out a crocket penis then surely their protagonists would only be too happy to demonstrate such by way of verifiable controlled clinical trial and not just anecdote. Yet search as you may, nowhere on the internet will you find anything even remotely approaching scientific evidence for the validity of these “cures”. Please correct me if I am wrong here, in the absence of such scientific evidence however I am inclined to dismiss all non-surgical conservative cures for penile curvature as entirely bogus. It’s your money at the end of the day.
Does Penile Curvature need to be treated? This of course is the real question that needs to be asked. Yes is the answer but never ever, in my opinion, for cosmetic reasons alone. Never subject yourself to penile surgery, and that’s what we are talking about, to have your penis straightened out just because you do not like the look of it or someone else does not like the look of. The risks of making things worse rather than better are just too great. As a stop-gap to formal surgery, injection of the offending scare tissue with long-acting corticosteroids may be worth considering. Again this will require careful research on your behalf.
In my opinion, the only man who should consider surgery to straighten out his penis is the one in a situation where things have progressed or seem to be progressing to where he can no longer have intercourse comfortably. As long as a man and his partner can have and enjoy intercourse comfortably then rushing into surgery is probably a mistake.
Surgery. It is very important I think that whoever is undertaking to operate on your penis to straighten it out has loads of experience in this regard and works in an accredited centre of excellence. Do not be afraid to ask the hard questions. Is the Urologist in question published for example? Do they have particular expertise in operating on penile curvature or is this something that they only occasionally turn their hand to because there is nobody else? What are their results? Can you talk to an ex-patient – very unlikely but no harm to ask?
There are two approaches to surgically dealing with the scar tissue that gives rise to the bend in you penis. One is to simply remove it and replace it with an expandable tissue graft. The other is to leave the scar insitu and fashion a shortening of the tunica on the contra-lateral side such that they balance each other out. What you should aim for is considerable and measurable improvement but not perfection because, in the majority of situations, perfection may simply not be attainable.