Bent penis or abnormal penile curvature is a physical conditions that can cause significant impact on men’s emotional, psychological and sexual confidence. There are two distincts type of conditions, Congenital penile curvature (CPC) and Peyronie’s disease.
Congenital penile curvature (CPC) also known as 'chordee' is a relatively uncommon medical conditions, however, the number of reported cases are increasing due to better awareness. It present since birth and sometime notice early during diapering. However, the curve is only become more noticeable during erection and patient often present in late adolescent or early adult.
The cause of CPC is not known, but it is thought as a result of an excessive elasticity in one aspect of the penis as compared to the rest of the penis. Typically the curve is downward but you can also get upward or sideways curve. Most patient do not experience pain on erection or during sexual intercourse and would not require any treatment especially when there is no detrimental effect to the sexual function. However, some men may feels conscious about this and would want to correct the curve. CPC can be treated with corrective surgical procedure.
Peyronie’s disease on the other hand is an acquired conditions caused by an excessive scar tissue (or plaque) formation leading to pain, erectile dysfunction and abnormal curvature. The plaque accumulate at the structure called 'tunica albuginea' which is an elastic tissue important to keep the penis hard during erection. However, as the plaques get thicker, it will pull the surrounding tissue inward causing the penis to bend more noticeably during erection causing pain and often difficult penetration. The plaques can develop anywhere along the penis, most commonly, about 70% of the time on the top causing the penis to bend upwards and sometime on the bottom or side of the penis, causing the bend to be downward or sideways.
Peyronie’s disease has two distinct stages, acute and chronic. During the acute phase, there is an on-going inflammation causing pain. This period can last up to 18 months. The penis will noticeably start to curve. After that, it will enter chronic stage when the pain has completely resolve and the curvature of the penis stabilizes.
The exact cause of Peyronie’s disease is unknown. However it is known to be associated with erectile dysfunction. Peyronie’s disease is significantly associated with other cardiovascular risk factors such as diabetes, hypertension, hyperlipidaemia, obesity and smoking. The occurence of Peyronie’s disease increases with age with peak incidence between the age of 55 to 60 years old. Some patient may vaguely remember trauma to the penis before the symptoms started and some may not. Patient with Peyronie’s disease may have significant physical and psychological distress. For patients who also suffered from erectile dysfunction , use of Phosphodiesterase-5 inhibitors such as Viagra and Cialis may be helpful. Other treatment options available for Peyronie’s disease includes Verapamil injection, shockwave therapy, PRP injection, mechanical traction, vacuum device and surgical treatment.
Practicing a healthy lifestyle by quit smoking, regular exercise, reducing alcohol consumption, eating a balanced nutritious diet and weight reduction can help to improve blood flow and help with erectile dysfunction related to Peyronie’s disease. Routine health checks-up is also important to screen for high blood pressure, diabetes and high cholesterol to detect early presence of chronic disease and for optimisation of the cardiovascular risks.
If you have issue with your penile curvature and it is affecting your sexual intimacy, talk to our doctor on the suitable treatment and preventive measures to help your symptoms.