Penile curvature: Diagnosis & Treatments

What causes penile curvature?

Penile curvature can be congenital or acquired.

Congenital curvature is discussed in this purpose as a distinct pathology in the adult population without any other concomitant abnormality present such as urethral or spongious corpus abnormalities.

Acquired curvature is secondary due to La Peyronie disease (referred to Peyronie’s disease). This point is not discussed in this purpose.

What is the diagnosis of penile curvature?

The medical and sexual histories are usually sufficient to establish the diagnosis of congenital penile curvature.
Physical examination during erection is useful to document curvature and exclude other pathologies.
Erectile function is normal, but it can be compromised by excessive curvature.

Congenital curvature is rare, and there is no evident cause. Studies report an incidence of less than 1%.

What are the treatments for penile curvature?

The treatment of this pathology is only surgical and can be performed at any time in adults.
The aim of surgery is to correct curvature and allow satisfactory intercourse.

The major type of repair for congenital penile curvature may be considered as shortening procedures.
Penile shortening procedures include the Nesbit wedge resection and the Plication techniques. All these procedures are performed on the convex side of the penis and are used almost exclusively with high curvature correction rates.

Nesbit operation

The Nesbit operation is based on a 5 to 10 mm transverse elliptical excision of the tunica albuginea or approximately 1 mm for each 10° of curvature. This excision is performed on the convex side of the penis and closed in a horizontal way.

Plication procedures use the same principle as the Nesbit operation but are simpler to perform. They are based on single (or multiple) longitudinal incisions closed in a horizontal way or on single (or multiple) plication knots without tunica albuginea incision.
All these techniques are performed on the convex side

of the penis.

single (or multiple) longitudinal incisions closed in a horizontal way.

The overall short - and long-term results of the Nesbit operation and the other Plication techniques are excellent:
Complete penile straightening is achieved in 67 to 97% of patients.
Recurrence of the curvature is uncommon (about 10%)
Risk of postoperative erectile dysfunction and penile hypoesthesia is minimal (less than 6%)
Penile shortening is the most commonly reported outcome. However, shortening of only 1–1.5 cm has been reported for about 85% of patients, patients often perceive the loss of length as greater than it actually is. Which is rarely the cause for postoperative sexual dysfunction.

Specific issues that should be mentioned during patient consent are the risks of penile shortening, the risks of recurrent curvature, the potential for palpation of knots and stitches underneath the skin, and the potential need for circumcision at the time of surgery.

About Men’s Health International Surgical Centre

MHISC is a collective group of five International and European recognized surgeons. Leading experts from England, France, Italy and Serbia have been brought together to establish a global centre of excellence in the fields of genital and urethral reconstruction, erectile dysfunction (penile implants), peyronie’s disease, genital reconstruction for trauma, cancer and male infertility.

The idea is to create a base in Europe which will carry out the above surgeries and treatment in a bespoke, boutique private facility. Patients travelling to the centre would be offered the best treatment available in a comfortable and luxurious setting.

Given the nature of the procedures performed, confidentiality is paramount and therefore establishing a centre in Europe would allow patients from around the world to travel with discretion. This is particularly the case with patients from the Middle East who are currently travelling outside the Middle East to have their surgeries carried out by our specialists.

Ideally located between Geneva and Lausanne, Clinique de Genolier offers sweeping views of Lake Geneva, Mont-Blanc and the Alps. A presidential suite and junior suites furnished in contemporary style and “La Table”, a gourmet restaurant, ensure an exceptional standard of hospitality for the patients.

With 106 beds and 198 admitting physicians, it is one of the largest private clinics in Switzerland. Clinique de Genolier offers specialist medical care, one of the most up-to-date operating theaters in Europe, an experienced medical team and premier-quality hotel services.

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