ICD codes for this disease: ICD codes are internationally valid medical diagnosis codes. They are found e.g. in medical reports or on incapacity certificates. Q55N48ArtikelübersichtPenisverkrümmung
- Causes and risk factors
- Examinations and diagnosis
- Disease course and prognosis
Penile curvature: description
In penile curvature, the penis is curved to one side (lateral), upwards (dorsally) or downwards (ventrally). Some penis is also corkscrew wound around its axis. A penile curvature can be innate and is called medically congenital penile deviation. In this case, the penis is usually bent downwards or in the erected state forward. An acquired penile curvature doctors call Induratio penis plastica (= plastic hardening of the penis). Here the erectile tissue is often bent upwards, in some cases also to the side.
A congenital penile curvature is based on a defect in the genetic material. Therefore, it often occurs with other diseases of the male genital organ. A specific cause for the acquired penile curvature is not known. Mainly 45- to 65-year-old men get a penile deviation. In Germany about three percent of this age group have a crooked penis. Overall, penile curvature occurs in about one in every 1,000 men. However, experts suspect a much larger number of unreported cases.
Often the curvature is only light. Over time, however, it can strengthen and disrupt the erection painfully. In other cases, deviations spontaneously return. Congenital penile curvature remains unchanged in most cases.To the table of contents
Penile curvature: symptoms
An acquired penile curvature is characterized mainly by palpable, nodular hardening, so-called plaques. They are usually at the top of the penile shaft, in rare cases at the bottom. The often elongated nodules arise from the tunica albuginea. It is a thin cuticle that surrounds and holds together the corpora cavernosa of the penis (corpora cavernosa) as a connective tissue-like capsule. The hardening occurs within a few weeks to months. They have a different size (usually one to three centimeters) and can spread to over the entire penis shaft.
Scarring and hardening of the connective tissue, experts call fibrosis. In a fibrosis connective tissue proliferates benign and is usually converted from a soft, elastic to a harder, scarred tissue. Through these changes (penile fibrosis) the tissue shrinks in the area of the plaques and thereby bends the penis on the diseased side. The acquired penile curvature is thus more of a symptom than a disease. The extent of penile curvature is especially visible on the erect penis. Occasionally, the penis bends in two directions (bidirectional penile curvature), for example, upwards and to one side.
If the crooked penis deviates significantly from the straight axis, this can lead to problems during intercourse. In addition, the penis becomes less rigid from the plaques to the glans, which experts call reduced rigidity. Some patients complain of pain, especially during an erection and during sex. At rest, these penile pains occur only very rarely. Urination and the urinary stream, on the other hand, are not restricted by penile curvature.
Occasionally can be found at acquired penile curvature plaques at the transition between the glans penis shaft and (Schnürfurche). As a result, hourglass-like constrictions may occur in this area. In severe cases, it can damage the nerves and vessels that run there. This leads to an erectile dysfunction (erectile dysfunction) and the glans tingles or feels numb.
In congenital penile curvature, the curvature itself is the main symptom. Typical complaints as with the acquired variant are rare. Most patients present themselves before or after their first sexual contact with a doctor. Depending on the extent of sexual intercourse may be affected. For some patients, penile curvature is also a psychological problem. Deviation from the norm often affects those affected as distressing. This is mostly compounded by a possible erectile dysfunction and problems with sex.To the table of contents
Penis curvature: causes and risk factors
The causes of penile curvature, as with the symptoms, differ between the innate and the acquired form. Proven reasons for Penisverkrümmungen missing so far. However, there are assumptions and clues that point to possible causes of Penisevviation.
Congenital penile curvature
The reason for a congenital penile deviation are defects in the genetic material. Where or why exactly the penis develops incorrectly, is hardly known. However, it is known today that the connective tissue envelope (tunica albuginea) of erectile tissue grows differently long. Most of the lower part is shorter than the upper part, which is why the male member is often curved downwards in congenital penile veining. In some cases, congenital penile curvature is associated with other diseases. These include above all:
- hypospadias: The mouth of the urethra lies below the glans, ie at the bottom of the penis. Underneath the urethral opening, which is too low, there is a thickened band of connective tissue, the chorda, leading to the testicle. She bends down the penis.
- Megalourethra: Balloon-like dilated urethra. Here are missing parts of the three erectile tissue of the penis. As a result, the urethra expands enormously. This developmental disorder often leads to a penile curvature upward.
- epispadias: There is a second urethral opening on the penile shaft.
Scientists believe that a lack of male sex hormones (androgens) during embryonic development is responsible for these malformations.
Acquired penile curvature
The cause of acquired penile curvature is unknown. However, experts have come up with a number of theories to explain how penile deviation can arise.
During sexual intercourse, the penis can easily bend, especially in the beginning erection. This burdens the connective tissue envelopes in the penis. As a result, the smallest lesions and injuries (microtrauma) of the vessels in the penis can occur at these sites. There are no visible bruises. Through an inflammatory reaction of the body, the tissue gradually scarred. The inflamed corporal tissue is replaced and there are the typical plaques and thus the penile curvature.
Whether some men are more susceptible to penile curvature than others by their genotype has not been proven to this day. However, scientists have found that about 25 to 40 percent of men with acquired penile curvature also suffer from Dupuytren's disease. Dupuytren's disease is a condition in which benign connective tissue proliferations result in nodules on the palm of the hand. The simultaneous occurrence of both suggests a genetic link.
Many men go unnoticed the smallest damage inside the penis. However, not everyone develops an acquired penile curvature. Some experts therefore assume a disturbance of the connective tissue metabolism. As a result, it is not the original, elastic fabric fibers that are used for repair, but harder fibers. The result of these remodeling processes can later be felt as typical nodules.
A study by the Faculty of Medicine in Istanbul, Turkey, also shows a connection between the blood sugar disease (diabetes mellitus) and the increased risk of developing penile curvature. The scientific journal BJU International also published a study, according to which diabetics have to reckon with a more severe course of induratio penis plastica. However, there is still a lack of sufficient patients to be able to really prove these connections.
Possible risk factors of penile curvature
Factors that favor the development of acquired penile vagina are poorly understood. So far one could not uncover the connection between illness and risk factors. However, the following risk factors are discussed in the scientific community:
- high blood pressure
- Smoking and alcohol
- Hard sexual intercourse
- Medications (for example, alprostadil for erectile dysfunction, where the penile curvature is a side effect)
- painful permanent erection (= priapism, here is the penile curvature as a late episode)
Penis curvature: diagnosis and examination
If you have noticed a penile curvature, pain during sexual intercourse or typical indurations on your penis, you should contact a specialist in the urinary and genital organs, the urologist. First, he will ask some questions about the complaints that occur. The urologist will not only talk about your physical changes, but also ask about possible risk factors and your love life.
- When did you notice the crooked penis?
- Was there a trigger for the change, for example, an injury to the penis?
- Has the penile curvature increased since the beginning?
- Do you notice the changes only on the erect penis?
- Can you feel small nodules or indurations along the penis?
- Are the changes causing you pain?
- Do you have problems with sexual intercourse? Can you maintain your erection during sex?
- Is your penis less stiff than before, sometimes only in some places?
Try to overcome your shame and answer the questions as openly and honestly as possible. This seems difficult, but urologists are trained experts. In addition to the kidneys and urinary organs, they also deal with problems and diseases of the male genital organ every day.
After the detailed discussion with the doctor, an examination of the male member usually follows. The doctor assesses whether the penile curvature is seen even in the non-erected state. Furthermore, he scans the penile shaft and examines him for possible hardening or nodules (plaques). The penis is stretched slightly. Thus, the urologist can not only determine the size, location and number of plaques, but also the penis length. As a result, the further course of the disease can be better recorded.