Penile curvature is a condition in which men develop a pronounced curvature in the shape of the penis during sexual intercourse or when erect. This can often occur as a natural difference, but can sometimes be a symptom of a medical problem such as Peyronie's disease. Penile curvature can affect a man's sexual health and cause discomfort, but it is treatable. The degree of curvature and the way it occurs play an important role in determining treatment methods. Treatment options range from medications to surgical interventions.
What is Penile Curvature (Peyronie's Disease)?
Penile curvature, medically known as Peyronie's disease, is a condition that causes an abnormal curvature of the penis, usually noticed during an erection. This condition is caused by hard tissue formations called fibrotic plaques located inside the penis. Peyronie's disease can cause pain during sexual intercourse, performance anxiety and psychological disorders. This condition, which can be seen in different severities in every man, can progress or remain stable over time. It is possible to alleviate the symptoms with early diagnosis and correct treatment methods.
Causes of Penis Curvature
Many different factors can play a role in the development of penile curvature (Peyronie's disease). The most common cause is repetitive microtrauma to the penis. Bending, straining or moving the penis in the wrong positions, especially during sexual intercourse, can cause tissue damage over time, leading to fibrotic plaque formation. These plaques cause hardening of part of the penis and curvature over time.
Genetic predisposition is also an important risk factor. People with a family history of Peyronie's disease are more likely to develop it. In addition, some connective tissue diseases, such as Dupuytren's contracture, have been linked to the development of this disease.
Hormonal imbalances, decreased tissue elasticity due to aging and blood circulation disorders in the penis are among other factors that can trigger penile curvature. Rarely, this condition can also develop after some surgical procedures or traumatic accidents.
In this disease, whose progression can be slowed down with early intervention, correct identification of the causes positively affects the treatment process.
Symptoms of Penis Curvature
Peyronie's disease is characterized by symptoms that usually develop and become more pronounced over time. The most common symptom is an abnormal curvature that is noticed when the penis is erect. The curvature can be upward, downward, to the right or to the left and is sometimes observed as a pronounced C- or S-shaped bend.
Pain associated with the curvature of the penis is common in the early stages of the disease. This pain usually increases during an erection, but as the disease progresses, the pain may decrease or disappear completely. However, the curvature may become permanent.
Another symptom is the sensation of hard plaques or lumps in the penis. These hardnesses are usually noticeable under the skin and cause bending in a certain part of the penis. Some men may also experience a shortening or thinning of the penis length.
Difficulties during sexual intercourse, erectile dysfunction and aesthetic concerns are also among the psychological and physical symptoms of Peyronie's disease. These symptoms can negatively affect a person's quality of life and self-confidence.
The severity of symptoms may vary from person to person. Therefore, consulting a urologist at an early stage is critical in controlling the disease.
Penis Curvature Diagnosis Methods
The diagnosis of penile curvature (Peyronie's disease) is usually based on the patient's complaints and physical examination findings. The first step in this process is to take a detailed medical history. Information such as when the curvature of the penis started, whether there is pain, the presence of erectile dysfunction and problems experienced during sexual intercourse are critical for the diagnostic process.
During the physical examination, the physician palpates the plaques under the skin of the penis. These plaques are usually hard and can be felt distinctly. The degree of curvature is assessed by observing the erect penis. For this reason, in some cases the patient may be asked to bring a photo of an erection taken at home or a temporary erection may be induced with medication in a clinical setting.
For a more detailed evaluation, penile ultrasound is a common imaging method. Ultrasound provides clear information about the size and location of the plaques and the blood flow in the penis. This plays a big role in planning the treatment process.
Non-Surgical Penis Curvature Treatment Options
Curvature of the penis (Peyronie's disease) may not always require surgical intervention. Especially in the early stages of the disease or in cases where the curvature is mild, successful results can be obtained with non-surgical treatment methods. These methods are applied both to reduce the physical curvature and to alleviate pain and erection problems.
One of the most preferred methods is oral medication. This treatment aims to reduce plaque formation by using anti-inflammatory and tissue regeneration promoting drugs. However, medication alone may not be effective in all patients; therefore, it is usually combined with other methods.
Topical creams and injection therapies are also commonly used. Some drug injections directly into the penis can help reduce curvature by softening the plaque tissue. The FDA-approved collagenase enzyme is the most well-known injection treatment in this field.
ESWT (shock wave therapy) is one of the non-invasive methods that have gained popularity in recent years. By intervening in plaques with low-intensity sound waves, both pain is reduced and tissue elasticity is increased.
In addition, penile traction (stretching) devices can help to correct the curvature and maintain the length of the penis with regular use. These devices apply tension to the penis in a controlled manner and provide straightening over time.
Penis Curvature Surgery Methods
If penile curvature (Peyronie's disease) is advanced and non-surgical methods do not provide sufficient results, surgical intervention can provide a permanent solution. Especially if the curvature is severe, makes sexual intercourse impossible or causes serious psychological discomfort to the patient, penile curvature surgery stands out as the most effective treatment option.
Surgical treatment is applied with different techniques according to the direction and degree of the patient's curvature, penis length and erection quality. The most commonly used surgical methods are as follows:
1. Plication (Straightening with Stitches) Method:
In this method, the curvature is stabilized by suturing the non-curved side of the penis. The operation is short and the healing process is fast. However, there may be some shortening of the penis length with this method. It is suitable for patients with mild curvature.
2. Plaque Removal and Patch (Grafting) Method:
If the curvature is very pronounced and the penis length is to be preserved, the curved plaque area is surgically removed and replaced with tissue patches (grafts). Although this technique is more complex, it provides an advantage in terms of preserving penis length. However, it is preferred in patients with good erection quality.
3. Penile Prosthesis (Penile Prosthesis Implant):
If the patient has both severe curvature and erection problems, penile prosthesis surgery may be the most appropriate method. Silicone-based prostheses are placed and both erection is achieved and the penis is straightened. It is a permanent and effective solution, but is usually performed as a last resort.
Although the postoperative recovery process varies according to the patient, it is usually possible to return to normal life within a few weeks. The patient's expectations, physical condition and erection quality should be carefully evaluated before surgical intervention.
Penis Curvature Surgery Process and Recovery
Penile curvature surgery is a procedure that is planned and carefully carried out by a specialized urological surgeon specifically for the patient's condition. A detailed evaluation is performed prior to the surgery; the most appropriate surgical method is selected taking into account the degree of curvature, penis length, erection quality and the patient's expectations. Generally, the surgery is performed under general or spinal anesthesia and takes 1-2 hours on average.
After surgery, the patient is usually discharged the same day or within a day. There may be mild pain, swelling or bruising for the first few days; this is part of the natural healing process. Painkillers and antibiotics recommended by the doctor should be used regularly.
The healing process takes an average of 4-6 weeks, depending on the surgical method used. During this period, physical activities should be limited and especially sexual intercourse should be suspended for a while. The doctor usually recommends a waiting period of 4 to 6 weeks for sexual intercourse.
Risks and Side Effects of Penis Curvature Treatment
Although the methods used to treat penile curvature (Peyronie's disease) are generally safe, as with any medical intervention, there may be some risks and side effects. Depending on the type of treatment, the general health of the patient and the degree of curvature, these effects may vary from person to person.
Medication and injections are usually limited to mild and temporary side effects. Temporary bruising, mild pain or swelling may occur at the injection site. In rare cases, allergic reactions or tissue sensitivity may occur. Some oral medications may cause systemic side effects such as stomach upset or headache.
Non-surgical physical treatments (traction devices, shock wave therapy, etc.) are generally low risk. However, if used incorrectly or irregularly, skin irritation, pain or unwanted changes in shape can occur.
With surgical interventions, the risks can be a little more serious. The most common postoperative side effects include shortened penis length, numbness, erectile dysfunction and scarring. Especially in plaque removal and grafting surgeries, temporary or permanent erection problems may occur during the healing process.
Who are Suitable Candidates for Penile Curvature Treatment?
Curvature of the penis (Peyronie's disease) can occur in each man with different severity and symptoms. Therefore, suitability for treatment is evaluated according to the stage of the disease, the severity of the symptoms and the general health status of the patient. Suitable candidates for treatment are usually individuals whose quality of life is affected by the curvature and whose sexual function is impaired.
In particular, patients with a curvature of more than 30 degrees, who have difficulty during sexual intercourse or who cannot have intercourse due to pain should be prioritized for treatment. In cases where the curvature progresses over time, does not stabilize or is accompanied by erectile dysfunction, the need for treatment increases even more.
The stable phase of the disease is an important criterion for surgical intervention. Generally, surgery can be decided at the end of the 6-12 month period when the curve is stabilized and the pain decreases. However, non-surgical treatments applied in the early period, that is, while the disease is progressing, can also give positive results in suitable candidates.
Penis Curvature Treatment Results and Permanence
Treatment of penile curvature usually gives successful results depending on the method applied and the severity of the disease. It is possible to both correct the curvature and improve the quality of sexual life of the patient with treatments started at the right time and applied under the supervision of specialist doctors. While non-surgical methods are effective in the early stage of the disease, surgical intervention offers more permanent solutions in advanced curvatures.
After surgical treatment, the curvature is largely corrected and most patients can have sexual intercourse normally. However, in some cases, effects such as shortening of the penis length or changes in sensation may be seen. This may vary depending on the type of surgery performed.
The permanence of the treatment results is directly related to the patient's lifestyle, the rules they pay attention to after treatment and their compliance with the doctor's controls. The risk of recurrence of the curve after surgery is low, but it cannot be said to be completely eliminated. Especially during the healing process, it is important to avoid habits that negatively affect vascular health such as smoking and alcohol.
In non-surgical treatments, regular use and patience are required. Although the improvements achieved with device or drug treatments may be permanent, some patients may develop curvature again over time. Therefore, regular follow-up after each treatment is of great importance.
