Curvature of the penis

Sexual medicine

SEXUAL MEDICINE TREATMENTS

Curvature of the Penis

Having a curved penis (or a bent penis as it is commonly called), is something that many men worry about, but it is very normal. Not all curvatures are considered pathological. It may be considered problematic when the curvature affects or hinders sexual intercourse, causes difficulties during urination, or pain to the patient.

PENIS CURVATURE

DEFINITION

Indication

Curved penises have different characteristics depending on the shape and how the curve was acquired.

The penis or phallic body can present with DEVIATIONS of various types:

1 Upwards: As is often the case in Peyronie’s disease.

Dorsal lateral curve

2 Downwards. This case commonly known as the recurvatum penis is generally a congenital defect (birth) and is usually observed from an early age when the penis has its first erections. The deviation is downwards and usually occurs in large penises.

Lateral curve

3 To the left.

Left lateral curve

4 To the right.

Right lateral curve

The deformity of the penis also varies depending on:

There are cases in which the penis curvature is associated with the urethra failing to grow. If the urinary duct is too short, it causes a “deformity,” which usually leads to psychological problems in patients. The deformity of the penis can create insecurity when having sex, and in many cases. It could directly affect or hinder sexual intercourse (and even has the risk of breaking the phallic limb during sexual play if the curvature is very pronounced).

The penis has two possible clinical forms:

A – The curved penis from the birth

The congenital curve on the penis results from the malformation of the cavernous and spongy bodies of the penis from the birth of the male. Surgical intervention is the only solution to this curvature.

Do you have pain in the penis?

75% of congenital curves are usually painless, even when very pronounced.

Info

Do you have pain in the penis?

75% The congenital curves are usually painless, even when very pronounced.

The specialist must assess when the curve should be operated. This will basically depend on the severity and difficulties the curved penis causes to the patient. It is first assessed at the physical level, from defining the difficulty or even impossibility of penetration during sexual intercourse or urination. And then at the psychological level, taking into account the trauma it is causing the patient.

The “congenital curve of the penis” is a morphological alteration. Correction is often required in cases where there is a sexual health problem or is simply cosmetic surgery for others.

B – The bend as a consequence of diseases or injuries.

Peyronie’s disease causes an abnormal curvature on the erect penis. It bends noticeably and can hinder penetration or even cause pain during intercourse. This condition usually appears after 40 years of age and can both be very uncomfortable and painful. Regarding the treatments, the first thing to note is the time elapsed since the curve appeared, the existing degree of the deviation, and how this curve affects sexual activity. Peyronie’s disease or Induratio penis plastica (advanced) is a disease that inflames the tunica albuginea, which is the fibrous membrane that covers the testicle and participates in erection. The origins of this disease are still being studied, but it usually appears related to diabetes, the consumption of certain medications and in some cases after receiving a blow to the limb during sexual intercourse.

Do you have pain in the penis?

3 out of 4 patients with Peyronie’s Disease have pain in the penis. More than half also have palpable nodules in the penis, retraction, loss of size and some erectile dysfunction.

Info

Do you have pain in the penis?

3 out of 4 patients with Peyronie's Disease have pain in the penis. More than half also have palpable nodules in the penis, retraction, loss of size and some erectile dysfunction.

Penis Curvature

Treatment Summary

This is short summary of the whole process: from the appointment request, to receiving the medical discharge after the treatment in some our Andromedi centers in Madrid, Seville or Canary islands (Tenerife)

Consultations Needed

Most times a medical consultation is necessary (the most special cases need two consultations) before attending the surgery of correction of penis curvature.

Hospital Stay

The average hospital stay is 24 to 48 hours after surgery to prevent complications and assess improvement.

Anesthesia Type

Anesthesia can be local (we recommend it) or epidural (from the waist down) in addition to a moderate sedative to put the patient into a light sleep.

Operation Time

The surgery to correct the penis curvature usually takes about an hour, and can be extended to two hours depending on the case.

Post-operative

Recovery time is three weeks after surgery and the patient must take care of his surgical wound hygiene.

Resuming Sex Life

Sexual relations can usually take place within a month after surgery, always paying attention to the integrity of the wound.

Non surgical treatment Peyronie (Xiaflex / Xiapex)

TECHNIQUES AND TREATMENTS

Treatments

One of the main characteristics of curved penises is the corpus cavernosum lacking symmetry. Usually, the curvature of the penis, especially the lateral curvature causes asymmetry between both corpus cavernosa.

Lontophoresis can be used to correct penis curvatures during the early stages. Thanks to lontophoresis, we can deeply apply a drug that eliminates the nodules causing the penile curvature.

In more severe cases, these problems are solved (for the congenital acquired curve) through surgical intervention. The biggest problem that usually comes with this operation is the reduction of the patient’s virile member. This is because until recently, the only thing that could be done was to cut the longer part of the corpus cavernosum to result in two equal bodies. The greater the curvature, the greater the amount needed to be cut.

Thanks to the in depth development and research on this technique, MD Natalio Cruz, head of the medical services of our Andromedi Clinics in Madrid, Seville and the Canary Islands, can guarantee that the shortening of the penis in these surgeries is reduced to a minimum, thus allowing it to maintain almost in its entirety the natural size of the penis. This procedure involves enlarging, using graft to shorten the cavernous body, and thus making the penis completely symmetrical without reducing the size. Another newly developed method involves the rotation of the corpus cavernosum. This method like the previous one, considerably eliminates the shortening of the penis thus maintaining 95% of the initial size before the surgical intervention.

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En cumplimiento del Reglamento General de Protección de Datos le informamos que los datos por Vd. proporcionados serán objeto de tratamiento por parte de Andromedi con la finalidad de prestarle el servicio solicitado y/o contratado. Los datos no se cederán a terceros salvo en los casos en que exista una obligación legal. Para más información puede consultarla pinchando aquí.

What is Shaeer's Cavernous Rotation Technique and what is it?

In 2006, Dr. Shaeer published a new technique developed in Cairo, based on the rotation of the corpora cavernosa and updated by the same author in 2008. This innovative technique reduces the shortening effects of traditional techniques with the same correction of the curvature and with very good results.

This technique consists of laterally rotating the corpora cavernosa so that the penis acquires a straighter appearance. This is achieved by accessing the corpora cavernosa by means of a double incision in the dorsal or posterior part of the penis (one for each corpora cavernosa) and performing a double suture to force them to maintain the rotation performed.

Rotation of the corpora cavernosa, published by Dr. Shaeer, is a novel and useful alternative treatment that should be considered for patients with congenital penile curvature, given its ease of performance and excellent results.

The new modifications proposed for the technique have improved much more, its cosmetic and functional results. They are particularly useful in cases of severe congenital curvature of the penis (when the curvature exceeds 60-90°).

This procedure reduces the shortening of the penis (risk that is run with other techniques) and avoids complications such as palpable nodules, scars in the corpora cavernosa and pain in the penis.

Se denuda el pene a través de una incisión coronal y se realiza una erección artificial.
Se diseca el paquete vasculonervioso en su totalidad y se realizan dos incisiones dorsales longitudinales en los cuerpos cavernosos, algo más separadas del septo y surco medio en la zona de máxima curva que en el resto.
Luego se practica una doble sutura continua con monofilamento reabsorbible de larga duración 4/0: la primera une las caras internas y la segunda las externas. Esta doble sutura lograr cerrar ambos defectos a la par que imprime una rotación a los cuerpos cavernosos que endereza otras técnicas más propias del tratamiento de la estenosis de uretra o del hipospadias. La primera intervención quirúrgica, como en tantas situaciones de la medicina es la que ofrece las mayores oportunidades de curación al paciente. Por supuesto, el equipo quirúrgico debe dominar estas técnicas y estar preparado para solventar situaciones que de otro modo podrían ser perniciosas para la funcionalidad del pene.
El acortamiento del pene que producen todas estas técnicas es algo que hay que dejar claro al indicar la intervención para evitar frustración en el paciente con el resultado quirúrgico. Este acortamiento supone uno de los mayores motivos de insatisfacción de los pacientes tras la cirugía. Por ello, algunas soluciones quirúrgicas empleadas en los últimos años como la de trasposición de albugínea en los centros Andromedi de Madrid, Sevilla, Marbella y Tenerife están dando resultados excelentes en términos de corrección de la curvatura congénita de pene con mínimo acortamiento de la longitud de éste.

Congenital penis curve

Corpora cavernosa rotation surgery

Corrected penis curve without loss of size

The step by step of the technique of rotation of the corpora cavernosa

A longitudinal dorsal incision was made in the dorsal part of each corpora cavernosa, and by double suturing the internal and external parts of the incision, a rotation of the corpora cavernosa is induced, resulting in excellent straightening of the penis.

Step 1

After administering local anesthesia to the penis (as with all penile, congenital, or acquired curvature correction techniques) and disinfecting the area to be operated, the penis is ready for surgery.

Step 2

Neurovascular dissection was not considered necessary in Dr. Shaeer’s original technique. However, this neurovascular bundle (or neurovascular bundle) can be dissected dorsally, especially if any additional plication or procedure is needed, avoiding any potential neurological and vascular damage.

Step 3

Two superficial longitudinal incisions must be made in the dorsal part of the corpora cavernosa, involving the external longitudinal layer of the tunica albuginea, preserving the internal circular layer.

These two incisions should be slightly curved instead of parallel, with a greater separation in the central part of the incision. In fact, the more severe the curvature, the greater the separation required.

Step 4

First, the surgeon closes the medial or internal edges with a continuous suture. Then a second continuous suture will approach the lateral edges.

Ideally, according to Dr. Shaeer’s recommendations, polyglactin 910 (Vicryl), poliglecaprone 25 (Monocryl), and polydioxanone (PDS) sutures appear to have a very long rupture strength retention profile and could be a good option.

Step 5

Here, the surgeon induces a post-surgical and artificial erection for the measurement of the penis and thus, to evaluate the residual curvature that could be left and the changes that could be made. The shortening of the length of the penis is usually quite small.

Step 6

Buck’s fascia and skin are closed with fast-absorbing sutures, a urethral catheter, and a compression dressing.

Frequently Asked Questions About Dr. Shaeer's Cavernous Rotation Technique

What are the results of this technique?

Very good results have been published with this technique, such as:

• More than 90% straightening of the penis was observed in all cases.

• With a minimum shortening of the penis (less than one centimeter).

• High patient satisfaction in the recovery of their sexual life.

• No postoperative complications.

What are the advantages of Dr. Shaeer's technique to eliminate penile curvature?

Among its advantages are:

• Does not leave scars. The cavernous body rotation technique does not cause scars or leave marks that could ruin the appearance of the penis due to the careful surgical approach and the delicate process of closing the open tissue, they are thin sutures.

• It does not leave nodules on the dorsal part of the penis, as it happens with other techniques. Nodules appear when the tissue is reattached in an inappropriate way and an exaggerated healing process occurs, resulting in accumulations of palpable tissue under the skin.

• The curvature correction is anatomical and smooth. With the cavernous body rotation technique, the penis can again have uniform erections and the patient does not usually perceive exaggerated or uncomfortable tensions. At first glance, a penis that has undergone this surgery is indistinguishable from one that has never undergone surgery.

• There is no shortening of the penis. This characteristic is by far one of the most important of this technique. The penis can achieve erections with the same length as before surgery, not less. This is because at no time does rotating the corpora cavernosa involve shortening or reducing the corpora cavernosa of the incurred area.

OPINION

Real testimonies from our patients

Hola a todos los que desde aquí habéis contactado al igual que yo en su día, con el Doctor Natalio. Quisiera desde aquí darle las gracias al Doctor Natalio y a su equipo por el gran trabajo realizado en la operación de incurvación congénita de pene a mi hijo de 12 años. Estamos muy contentos por el resultado y que decir de mi hijo... El ha ganado en autoestima, seguridad en sí mismo, se siente feliz y por supuesto, animamos a todos los que tienen el mismo problema a que contacten con el Doctor Natalio y les comenten su problema. Es un excelente profesional y una entrañable persona. Decir que por la corta edad que tiene mi hijo teníamos muchísimo miedo pero mereció la pena, pues la felicidad que mi hijo desprende ahora, eso es lo más importante y esos cambios han sido gracias a la intervención quirúrgica que ha sido todo un éxito. Gracias Doctor Natalio a usted y a su equipo. Un saludo de una madre agradecida, ah y un beso muy grande de Kike.

Lidia, Madre de Kike

Madre de Kike, paciente de 12 años de edad operado de Curvatura Congénita de Pene

Mediante este medio, quiero expresar mi profundo agradecimiento al Dr. Natalio Cruz y su equipo de especialistas, que pudieron solucionar mi problema que venía teniendo desde hace varios años. Gracias a la preparación de un planning adecuado, pude movilizarme hasta Sevilla, y que me realicen la operación para corregir la curvatura congénita de pene de la que sufría. Muchísimas gracias Dr. Cruz por transmitirme confianza y seguridad en todo el proceso que duró mi recuperación, ahora ha mejorado mi autoestima y estoy mas confiado en el desarrollo de mi vida sexual. Esperando de que todo le vaya muy bien y que así como pudo ayudarme a mí, siga ayudando a más pacientes a llevar una mejor calidad de vida. Agradecido por siempre.

Juan

Paciente de curvatura congénita de pene

Quisiera mostrarle mi agradecimiento por la intervención y por el trato personal que me ha dispensado no puedo tener mas que palabras de elogio a Vd. y todo su equipo de profesionales. Sin ninguna duda, ponerme en sus manos fue la mejor elección que pude tomar, me sentí muy cómodo en todo momento tanto en su consulta, como en el hospital de NISA de Sevilla, donde mi estancia fue muy agradable por el trato recibido. Reciba un cordial de saludo.

Andrés

Paciente de Curvatura de Pene

SOLUTIONS

Results

About 99% of cases with this problem have a solution. The penis maintains its full sexual and reproductive functionalities. After the operation, the patient retains 95% of the initial size of his penis.

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Madrid

Sevilla

Canarias

Medical evaluation

Tips

We must not delay and need to get the surgery done immediately the malformation is detected.

It is much better if performed before the male becomes sexually active so that he begins with a full and healthy sexual life.

The sexual health of men is key in their development and emotional stability, and taking care of them from a very young age is very important.

When dealing with these patient treatments, we must remember that they usually arrive with fear and distrust due to misinformation.

“The discretion in the consultation and empathy in combination with the importance of maintaining the size of the penis are fundamental for good doctor/patient understanding in these types of treatments.”

Sexual medicine

SEXUAL MEDICINE TREATMENTS