urology Penile Curvature

Penile curvature is a condition, some patients have a curvature in the penis shaft during erection. The problem is generally recognized during puberty or early adulthood. Curvature could be mild to sever, bend to either left or right , upward or down wards.

 What are the causes of penile curvature?

Cause s of penile curvature are

  • Congenital
  • Peyronie's disease.
  • Trauma
  • Prominent frenulum

The congenital curvature is a problem that men are born with. Diffrential growth of the two corpora cavernosa ( two cylinders that give erection to penis) leads to curvature of the shaft towards the normal and longer cavernosa. Thus bend can happen to either to right or to left.

The exact cause of Peyronie's disease is not known. In this disease common among diabetics, a plaque of scar forms over the upper surface of the penile shaft. There could be several possible agents that cause this scar, like elevations in serotonin, Vitamin E deficiency, genetic causes or beta-blocking medications. Some researchers are of the belief that minor vascular traumas to the pens during exercises or sex occurring repeatedly can cause scar formation.

Trauma to the cavernosa like penile fracture can result in scar formation and thus curvature.

Prominent frenulum pulls down the glans down words and cause bent glans.

What are the symptoms of penile curvature?

The condition is usually first recognized around puberty or the early adulthood as erections start happening then. Penis looks normal when not erect. Many adult boys recognizes it as they find it difficult to have sex because of the curvature. Both partners can experience pain while having intercourse.

The symptoms of Peyronie's diseases, on the other hand, can be a combination of one or more symptoms, like:

  • an unusual angulation of the penis
  • pain during erections or sex
  • a plaque or scar on the upper surface of the shaft of penis
  • anxiety or stress
  • erectile dysfunction
  • an inability to have intercourse

What are the different phases of Peyronie's disease?

Peyronie's disease can be usually divided into two phases:

  • The acute phase continues for the starting 18 to 24 months and causes the most pain
  • The chronic pain begins after the acute phase where the pain is less. However, the plaque or the scar cause more curvature and becomes more refractory to treatment and might be beginning to develop large deposits of calcium

Diagnosis.

Diagnosis is obvious appearance of the bend on erection. Most of the time patient himself comes with the complaint. Erection can also be created in the hospital by drugs to measure the severity of the curvature.

Doppler. Doppler of the shaft of the penis gives the differential size of the carpora cavernosa, size and extent of the scar in Peyronie's disease.

Treatment.

Penile curvature

Not all curvature needs treatment. Only those curvature that are causing problem in penetration and pain while having sex needs to be treated. Only treatment is by surgical correction. By surgery the short carpora is lengthened or the long one is shortened to make both carpora uniform thus the bend is corrected. Many a time surgical correction is done for cosmetic reasons

Peyronie's diseasse.

Not all patients of peyronie’s disease needs treatment. In early disease there are several types of treatments are available to reduce the symptoms

Vitamins, supplements and medications - Nowadays different injections are available to treat patients with this condition. In the early stages, some drugs might also be used. These are aimed at breaking up the collagen that is causing the curvature deformity.

Shockwave therapy - The therapy is provided with a lithotripter device (such devices are also used to break kidney stones). it is used on plaque or scar that has been calcified. There have been some successes with these methods.

Steroid injection to the scar directly can reduce pain and slow down the progression of the disease.

Surgery -. It is usually done when other methods have failed. The surgery would involve excision of the scarred tissu, with or without auto-grafting or artificial grafting material to cover the defect. Penile implants can also allow the patients to sustain an erection.

Penile curvature can be treated easily when ever it is required. Treatment should be sought with out hesitation.

Authored By : Dr. Mahendra Jain

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