Penile Curvature

What is penile curvature?

Penile curvature is a curve in your penis when you have an erection.Your body is unique, and not all penises are the same size, shape or appearance. Your penis may be straight when you have an erection. But it’s also natural to have some curvature — your penis may curve up, down or to either side. You may be born with penis curvature, or it can develop later in life. However, it’s a good idea to see a healthcare provider if:

• You have a curve in your penis that’s bothersome to you or your partner(s).
• Your penis hurts, especially while having sexual intercourse or masturbating.
• Your penis causes pain or discomfort for your sexual partner(s).

These could be signs of a more serious condition.

What is normal penile curvature?

Penile curvature typically ranges from 5 to 30 degrees. A 5-degree curve in your penis looks like when the hands of an analog clock read 9:13. A 30-degree curve looks like when the hands read 9:10.What are the types of penile curvature?Types of penile curvature include:

• Congenital penile curvature (chordee). A chordee is penile curvature that’s present at birth (congenital). Most people don’t notice they have congenital penile curvature until they go through puberty.
• Peyronie’s disease. Peyronie’s disease is when scar tissue causes your penis to bend later in life. It’s unclear what causes Peyronie’s disease. Some medical researchers think it might develop after an injury to your erect penis, but most people with Peyronie’s disease don’t remember any specific injuries.

Symptoms and Causes

What are the symptoms of penile curvature?

The main symptom of penile curvature is a curve or bend in your penis.Other symptoms may include:

• Your penis appearing to twist or rotate (penile torsion).
• Lumps in your penis.
• A loss of length in your erect (hard) penis.
• Loss of girth in your penis shaft. Your shaft may look like it has an indent or an hourglass shape.
• Difficulty getting or keeping an erection.
• Your erection not being as hard as it used to be.
• Pain when you have an erection.
• Pain or difficulty while having sexual intercourse.

Penile curvature can also affect your mental health. It can affect you psychosocially (how other people affect your thoughts and emotions) and psychologically (how you think about yourself and your behavior). You may experience:

• Anxiety.
• Depression.
• Stress.

What causes a curved penis?

A slight curve to your penis is normal and somewhat expected. If you have a more pronounced curve, its cause isn’t always clear.Healthcare researchers aren’t sure what causes congenital penile curvature. It may relate to one side of the penis being stretchier (more elastic) than the other.Some researchers believe injuries to an erect penis may cause Peyronie’s disease. Injuries may occur:

• During sexual intercourse with a partner. If your penis slips out of your partner, you may accidentally thrust it into the area between the genitals and anus (perineum). Some sex positions can also lead to a shift in your partner’s weight that causes your penis to bend, such as if your partner is on top or if you’re behind your partner (doggy style).
• Energetic or forceful masturbation.
• Rolling over or falling onto your erect penis.

Obvious injuries aren’t the most common cause of Peyronie’s disease. Smaller, unrecognized injuries during regular masturbation or sexual intercourse may also cause penile curvature.Is penile curvature contagious?No, penile curvature isn’t a symptom of a sexually transmitted infection (STI). If you have penile curvature, you can’t spread it to another person.

Does penile curvature affect my fertility?

No, penile curvature won’t affect your ability to have a biological child.

Diagnosis and Tests

How is penile curvature diagnosed?

A healthcare provider can usually diagnose penile curvature by:

• Reviewing your medical history.
• Asking questions about your symptoms and sexual history.
• Conducting a physical examination.

During the physical exam, they may need to look at your penis when you have an erection. They may give you an injection (vasoactive drug) that temporarily makes your penis erect.What tests will be done to diagnose penile curvature?A healthcare provider may order a penile duplex Doppler ultrasound. This test uses sound waves to show how blood flows through the blood vessels in your penis. It can reveal scarring. They might also use a goniometer. A goniometer is a tool that measures the curvature of an erect penis.

Management and Treatment

Can penile curvature be fixed?

You may not need treatment if you have a slight curve that doesn’t hurt or prevent you from having sexual intercourse. If you need treatment, your healthcare provider will refer you to a urologist to discuss your options. A urologist is a healthcare provider who specializes in conditions that affect your urinary system and reproductive system. Your treatment options may include:

• Traction therapy. Traction therapy uses an external device — such as a vacuum erection device or traction device (RestoreX®) — to gently stretch your penis or bend it in the opposite direction of the curve. You may need to use the device for several months.
• Medications. Your provider may inject a medication directly into your penis that helps break down scar tissue. They may also prescribe oral medications that you take by mouth that help improve blood flow to your penis.
• Surgery. A surgeon may remove scar tissue or use stitches to reduce the curve. They could also recommend a penile implant. A penile implant is a medical device that allows you to have a straight, hard erection whenever you want. You can deflate the implant when you no longer want an erection.

Can you straighten penile curvature naturally?You shouldn’t try to straighten penile curvature on your own. Without the expertise of a healthcare provider, you could make the curve worse.

Will penile curvature go away?

Penile curvature rarely goes away without treatment. In mild cases, your symptoms may go away on their own. But in severe cases, your symptoms may remain or slowly get worse. Talk to a healthcare provider if you’re worried about penile curvature.

Prevention

Can penile curvature be prevented?

You can’t prevent congenital penile curvature. But you can help reduce your risk of injuries to your penis that may lead to penile curvature.As you age, your erections may get softer, or maintaining firmness may be more challenging. Softer erections have a greater risk of bending unexpectedly during sexual intercourse. Oral erectile dysfunction medications such as sildenafil (Viagra®), vardenafil (Levitra®) or tadalafil (Cialis®) increase blood flow to your penis. Greater blood flow to your penis helps maintain hard erections. These medications require a prescription, so it’s a good idea to talk to a healthcare provider as soon as your erections become softer.You can also help reduce injuries by exercising caution while having sexual intercourse:

• Use lubricants (lubes) to help reduce friction.
• Guide your penis if you change positions or if your penis slips out.
• Be careful when your partner’s on top or if you’re behind your partner.

Outlook / Prognosis

What can I expect if I have penile curvature?

It’s important to remember that it’s completely normal to have some penile curvature. Even if you have a curve that’s greater than 30 degrees, you may not need treatment if it doesn’t cause any symptoms or prevent you or your partner(s) from comfortably having sexual intercourse.If you get treatment, it may take weeks or even months to see the curve decrease. This can be frustrating, especially if penile curvature prevents you from having sex. Don’t wait to seek treatment. The earlier you see a provider, the faster you’ll see improvement.

Living With

How do I take care of myself if I have penile curvature?

The following tips can help if you have penile curvature:

• Be honest with your partner or partners. Be open and honest with your partner(s) about your penile curvature and your feelings. Encourage them to be open about their thoughts and feelings, too.
• Talk to a urologist. A urologist has special training to diagnose and treat penile curvature.
• Talk to a sex therapist. A licensed sex therapist can help you or your partner(s) process potential causes of stress, especially if penile curvature makes sexual intercourse difficult or impossible.
• Talk to a psychologist or psychiatrist. Changes to any part of your body can be stressful and cause feelings of insecurity, especially part of your genitals. A psychologist or psychiatrist can help treat any conditions that affect your mental or emotional health.

When should I see a healthcare provider?

It’s a good idea to see a healthcare provider as soon as you notice changes to your penis, especially if it gradually worsens, causes pain or other symptoms or prevents you and your partner(s) from comfortably having sexual intercourse.When should I go to the ER?Go to the nearest emergency room if:

• You have an erection and hear a cracking sound followed by severe pain, immediate loss of your erection and bruising or swelling in your penis
• You can’t pee.
• You notice external bleeding.

What questions should I ask my healthcare provider?

• How severe is my penile curvature?
• What caused my penis to curve?
• What should I do if the curve gets worse?
• Will the curve go away or do I need treatment?
• What treatments do you recommend?
• Do you think I need surgery?
• Can you recommend a sex therapist or psychiatrist?

A note from Cleveland ClinicHaving some curve to your penis is natural when you have an erection. It may curve up, down or to the left or right. This isn’t a problem as long as it doesn’t cause pain or prevent you from having sexual intercourse. Curvature may also develop over time, which can be alarming. Any changes to a sensitive area can make you feel insecure. You may even be hesitant to have sexual intercourse. It’s natural to have these feelings. But you don’t need to process these feelings on your own. Talk to a healthcare provider if you have concerns about penile curvature, especially if it causes pain or makes sex difficult or impossible. The sooner you talk to a provider, the sooner you can get a proper diagnosis and the appropriate treatment.

Our Doctors of the Department

Doç. Dr. Uygar Miçooğulları, FEBU

Urology