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Created Date: پنج شنبه 11 تیر 1392 Visit Count: 1785 Comments: 4 Author: host
Penile curvature
Penile curvature can be congenital or acquired. Congenital curvature is discussed in this article as a distinct pathology in the adult population without any other concomitant abnormality present (such as urethral abnormalities).

Penile curvature can be congenital or acquired. Congenital curvature is discussed in this article as a distinct pathology in the adult population without any other concomitant abnormality present (such as urethral abnormalities). The direction of curvature is important in predicting whether penile curvature will cause problems for an individual. Dorsal curvatures (toward the stomach) of 40 degrees or less usually do not require surgery. Curvatures greater than 40 degrees can produce significant penile discomfort during intercourse. When curvature reaches 50 degrees or more, vaginal penetration may be difficult or impossible. We have seen penile curvature greater than 90 degrees on many occasions. Lateral and ventral (downward) curvature can be more problematic than upward curvature. Curvature of 30 degrees in those directions may make intercourse difficult or impossible.

Symptoms

Patients with this condition describe curvature of the penis during erection that has been present for as long as they can remember. It is usually first recognized around puberty or early adulthood. It differs from Peyronie’s disease in that there is no scar tissue within the penis, and the condition usually does not change over time.

Causes | Risk Factors

This is usually a congenital condition, meaning men are born with it.

Treatment

In mild forms it does not require any treatment. However, when the degree of curvature interferes significantly with the ability to have sexual intercourse, surgical correction is indicated.

Penile curvature correction surgeries

Penile curvature is not an uncommon condition affecting men.

Penile curvature could be corrected with

1. Penile plication surgery

  1. Advantage - Low risk of erectile dysfunction
  2. Disadvantage - Penile shortening

2. Penile graft surgery

  1. Advantage- Penile length preservation
  2. Disadvantage- Higher risk of erectile dysfunction

3. Penile prosthesis

  1. Advantage- Treat underlying erectile dysfunction
  2. Disadvantage- Risks associated with penile prosthesis

What preparation is required?

Since the penile surgery is performed under general anaesthesia, you should have nothing to eat or drink for 6 hours prior to treatment. Regular medications can be taken with a sip of water with the exception of blood thinning agents (eg. warfarin, aspirin, clopidogrel) or non-steroidal anti-inflammatories which need to be stopped for 7-10 days. A mid stream urine (MSU) test is required to ensure the urine is sterile before treatment is undertaken.

What are the risks?

When performed by expert surgeon, penile curvature correction surgery is considered a safe procedure. Surgical complications depend on the complexities of your penile curvature and the type of curvature correction surgery. Some of the common postoperative complaints include:

  • Pain
  • Bruising or hematoma
  • Dysuria from urinary catheterisation
  • Skin irritation or mild infection

Potential serious complications include:

  • Temporary decrease sensation to the glans of penis
  • Potential penile shortening
  • Injury to the urethra
  • Development of erectile dysfunction
  • Recurrence of penile curvature

What to expect afterwards?

You are usually discharged the same day and you can remove the surgical dressing and have shower the next day. You will be discharged with 7 days of oral quinolones antibiotics. At home you should rest and avoid strenuous physical exertion for 4-6 weeks. During this time, normal spontaneous penile erection is common but any sexual activity is discouraged.

Follow-up

You will have a follow up appointment scheduled at 4-6 weeks postoperatively.

 

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