Severe curvatures (40 degrees+) can of course physically interfere with the enjoyment of sex for the man or his partner, and therefore merit correction on functional grounds.
However, mild (10-20 degree) penile tilts, curvatures or rotations are part of the spectrum of normality and are usually of no functional consequence.
Nevertheless, even if a bend is not causing functional problems, some men may still wish to have a corrective procedure for purely social and cosmetic considerations.
Penile curvatures can be constitutional (present as long as one can remember) or acquired later in life (Peyronie’s disease, injury).
Constitutional curvatures may be obvious in childhood, but often are first noticed and start to cause anxiety in adolescence.
Peyronies disease on the other hand is most common in the 50s and 60s age group, and rarely presents before middle age. It is an inflammatory condition that produces scarring and curvature in the penile shaft and is often painful during the early stages. Fortunately it is usually a self limiting disease and many cases can be managed conservatively without the need for any surgical intervention.
Management of penile curvature. Non-surgical. Patients with mild constitutional curvature may need nothing more than reassurance that it is within the range of ‘normality’. Some, despite reassurance, nevertheless want improvement in the shape, but are keen to avoid surgery.
The use of penis traction devices may offer a worthwhile solution, and might well be suitable for those with sedentary lifestyles, but it requires much patience and motivation to wear such apparatus regularly for prolonged periods of time.
Peyronies is also managed conservatively during the initial active phase of the disease. Indeed, in a proportion of patients, after the inflammatory process has subsided, the bend may become less troublesome and the shape improve spontaneously over time. Surgical.
Surgery usually consists of placing internal buried sutures in the penile shaft that shortens the longer convex side of the curvature to match the shorter concave side.
In practice, any resulting reduction of penile length only becomes an issue when correcting a severe curvature on an already short penis.
Surgical shortening of the the long side is a much simpler and safer procedure than trying to lengthen the short side of the bend, and is the best option in most situations.
It can usually be done as a day case procedure in children, though we usually recommend an overnight stay in hospital for adults.
Abnormal erection angle. Some men have a very high erection angle, such that the penis points vertically and lies almost against the abdomen.
This may cause pain or mechanical difficulty with penetration during sex. It can be improved surgically by releasing the dorsal suspensory ligament of the penis so that the penis will stand up at a lower angle.
Conversely, a deficient or damaged suspensory ligament may cause the penis to be unstable and to hang downwards even when fully erect.
This can also be improved by surgically adjusting the attachments at the base of the shaft.
