What is Penile Curvature (Peyronie's Disease)?

Penis Eğriliği

Normal erection in men occurs when the penis is straight and at a right angle. Contrary to this situation, penile curvature is defined as the fact that the penis is oriented in any direction during erection.

How is Penile Curvature Recognized?

There are different causes of bent penis discomfort. While some penile curvatures are congenital, penile curvature may occur due to different reasons in later ages. While there is usually no pain or ache in congenital penile curvature, which is also referred to as the Sunnah of the Prophet, the first symptom of Peyronie's disease, which occurs in later ages and causes curvature in the genitals, is pain in the genitals. Although Peyronie's disease is a disease that is usually seen after the age of 50, it can be seen in two periods as acute and chronic. In the acute period, patients feel pain in the penis during erection.It is very important for people with Peyronie's Disease to apply to specialist physicians when they feel erection pain. If left untreated, this period lasts for about 18 months and the disease progresses to the chronic stage. In the chronic period, oblique penile condition can be observed in patients. In Peyronie's disease, abnormal hardness (plaques) are also seen on the penis.

In congenital penile curvatures, on the other hand, due to the fact that the urinary hole is not in its normal place, it can cause difficulties while urinating, not being able to empty the urine completely, and sometimes infection and burning in the urinary tract, depending on the location of the hole. Although congenital penile curvatures can only be noticed during the first puberty periods, they can be understood with careful observation of a specialist during childhood.

Why Does Penile Curvature Occur?

There are two different types of penile curvature. One of them is congenital penile curvature. The other is penile curvature disease that occurs in later ages. Penile curvature disease, which is experienced in advancing ages, may occur as a result of some diseases, surgical interventions or traumas.

Congenital Penile Curvature

There are three spongy tissues on the penis. Two of them provide the blood circulation required for erection, while one provides urine discharge. In congenital penile curvatures, there is a delay in the development of one of these spongy tissues. For this reason, when it comes to puberty periods, an inclination occurs in the opposite direction of the normal spongy tissues of the penis in erection. However, disorders that occur with birth and are commonly called the sunnah of the prophet can also cause penile curvature afterward. In these disorders, whose scientific name is "Hypospadias", the urinary hole in the penis is not in its normal place. For this reason, problems are experienced during urination and sexual intercourse. The problem of “hypospadias” is another reason that causes penile curvature over time.

Non-Congenital Penile Curvature

Penile curvatures that are not congenital and that we encounter in advanced ages (usually after the age of 50) are generally caused by calcifications in the penis called "Peyronie". In Peyronie's disease, calcifications occur between the spongy tissue in the penis and the outer sheath. In this disease, acute and chronic two stages are observed, in the first stage more pain in the penis, and in the next stage, penile curvature occurs over time. Apart from this disease, one of the non-congenital penile curvatures is penile curvature that may occur as a result of some surgical operations on the penis.

How does Penile Curvature Occur?

There may be different causes of penile curvature. Diabetes diseases, some tissue diseases and genetic factors can be triggering factors. However, the most common cause of penile curvature is trauma during sexual intercourse or damage to the penis during erection. As a result of such traumatic events occurring in the penis, after the bleedings under the penile heal, they can turn into hard connective tissues under the penile sheath over time. This may cause the direction of the penis to show anomaly in case of erection over time. Especially after the age of 40-50, the risk of strain on the penis increases due to easy injury and difficult healing in this region. The incidence of penile curvature in men is as follows.

Frequency of Penile Curvature and Peyronie's Disease in Men

Congenital Penile Curvature 8-10%
Ages 30-39 1,5%
Ages 40-49 3%
Ages 50-59 3%
Ages 60-69 4%
Over 70 6,5%

Penile Curvature Diagnosis

Penis Eğriliği

Penile curvature is usually first noticed by people themselves. However, especially congenital penile curvatures can be detected in childhood as a result of careful control by specialist doctors. In Peyronie's diseases, it is possible to treat the disease before penile curvature occurs if specialist urology specialists are consulted as a result of penile pain. In Peyronie's diseases, if there is stiffness on the penis, it is detected by the physical control of the doctor, and both ultrasound and MRI examinations of the patient are performed with these determinations. Men who notice penile curvature or abnormal hardness on the penis should definitely see a specialist urologist. In case of progression of penile curvature and Peyronie's disease, treatment will be difficult and there will be problems in having sexual intercourse. In addition, ejaculation problems, infertility and painful erection, as well as psychological problems caused by failure in sexual intercourse, are also problems that can be experienced by people in the case of curvature of the penis.

Early Diagnosis in Penile Curvature

If the problem of penile curvature progresses, physicians have no choice but to undergo surgical intervention. However, in cases where it is detected early, it is possible to treat the penile curvature problem with methods such as drug therapy or shock therapy. Apart from treatment methods, men who have penile curvature problems will not only reduce the quality of their sexual life, but also decrease their overall quality of life unless this problem is treated. Therefore, early diagnosis and treatment of the disease is very important.

Disease Course of Penile Curvature

If penile curvature is not congenital, pain is felt in the penis during erection in the first stage of the disease. However, this painful period is not permanent. Along with pain, there may be stiffness under the skin in the penis during erection. Since it can disappear without treatment, it is very important to consult a doctor in this type of painful period. If the disease is not diagnosed and treated during this painful period, the so-called chronic period begins. In this period, although it differs from patient to patient, curvature of the penis and hard layers under the skin on the penis begin to be felt.

Penile Curvature Treatment

The treatment of the problem that the urinary hole is not in its normal place, which is called the sunnah of the prophet from birth, is treated with surgical methods. In the operation, both the location of the urinary hole is changed and the curvature of the penis, if any, is corrected. For curvatures caused by Peyronie's disease, which are not congenital and occur in later ages, treatment methods vary depending on the diagnosis in the acute and chronic periods.

Peyronie's disease detected in the acute phase is mostly treated with medication. Since plaque formation has not fully started in this period, drug therapy can be effective. Along with drug therapy, shock therapy, which is given ESWT ADI, can also be applied during this period.

The chronic period is the period that begins after the painful period in Peyronie's disease and the curvature and deformities of the penis begin. During this period, drug therapy is usually no longer effective. For this reason, injection into the penis, ESWT shock wave therapy or surgical intervention methods are preferred as a treatment method for penile curvature detected in the chronic period. In addition to these methods, in addition to surgical intervention, penile prosthesis, also known as the happiness stick, can be inserted in patients with increased deformity in the penis.

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