Introduction:
Penile curvature disorder belongs to a group of disorders classified under Peyronie's disease. Penile curvature disorders are frequently noted in individuals suffering from hypospadias (a congenital disability in boys where the opening of the urethra is not located in the tip of the penis). Penile curvature disorder is a broad-spectrum disorder not always associated with hypospadias, but it may also be noted in individuals with normal meatus. The prevalence of hypospadias is around one in three hundred male births. The incidence of penile curvature in males is around four to ten percent of a male birth. Researchers have listed various theories related to penile curvature disorder. Penile curvature is noted to be a complex problem for pediatric urologists. Many surgical approaches have been planned to treat penile curvature, but various procedures are also associated with a few complications.
What Is Meant by Abnormal Penile Curvature in Children?
Hypospadias (a congenital disability in boys in which the opening of the urethra is not located at the tip of the penis) and various other genital abnormalities are noted to be associated with abnormal penile curvature. A few genital disorders related to penile curvature in children are as follows:
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Urethral Hypoplasia: Small urethra leading to decreased urine stream.
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Cryptorchidism: Condition in which the testes fail to descend from the abdomen to the scrotum.
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Penoscrotal Transposition: Congenital external genital malformation.
At the time of physical examination by the doctor, the degree of curvature of the penis can be determined only when the penis is fully erected; this is a complication doctors encounter in determining the exact curvature of the penis. So, the exact curvature and angulation are determined only at the time of the surgery. In most cases, the penile curvature can be corrected by minor surgical procedures; further, no treatment is required.
What Is a Significant Degree of Penile Curvature?
Penile curvature, around 20 to 25 degrees in children, is considered to be significant and requires medical attention and surgical intervention. However, at the time of physical examination by the doctor, the degree of curvature of the penis can be determined only when the penis is fully erected; this is a complication encountered by doctors in determining the exact curvature of the penis. So, practically, the exact curvature and angulation are determined only at the time of the surgery.
What Is a Peyronie's Disease?
Peyronie's disease is an acquired inflammatory disease affecting the male genital organ, the penis. Peyronies's disease begins after forming a flat small scar tissue within the penis. This scar tissue is not a tumor but may lead to complications such as penile curvature disorder or, in a few cases, painful erection.
What Are the Common Symptoms Associated With Peyronie's Disease?
Following are a few common symptoms associated with Peyronie's disease:
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Plaque is formed in individuals suffering from Peyronie's disease, resulting in upward bending or curvature of the penis during the erection phase.
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In a few individuals, multiple plaques may be present, leading to a complex curvature of the penis at the time of erection.
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In severely complicated cases, these plaques may calcify and may result in shortening or shrinkage of the penis.
What Are the Causes of Peyronie's Disease?
Following are a few common causes of Peyronie's disease:
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Minor penile trauma.
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Vigorous sexual activity may lead to trauma from a partner's pubic bone.
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Sports injury.
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Various studies have proven that excessive tobacco intake may lead to Peyronie's disease and other erectile dysfunction disorders.
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Abnormal wound healing post-trauma can also lead to this disorder.
What Are the Diagnostic Criteria for Penile Curvature?
The following are the diagnostic criteria associated with penile curvature:
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Experienced urologists can identify the presence of any plaque or scar tissue leading to penile curvature through medical and physical examinations.
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Ultrasonography is also advised for diagnosing penile curvature disorder and other associated conditions.
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The radiographic examination helps identify any calcium deposits in the plaque or scar tissue leading to penile curvature.
What Are the Pharmacological Approach for Treating Penile Curvature Disorders?
Following are a few pharmacological approaches for treating penile curvature disorders:
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Vitamin E Supplements: Vitamin E is a rich source of antioxidants and is important in treating the acute stage of penile curvature disorder. It is highly recommended because of the least side effects and low treatment cost.
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Potaba is a short form used for potassium ammonium-benzoate. It is an expensive treatment, and its dose regimen includes 24 pills per day for up to six months. It is associated with side effects like diarrhea, so this treatment is less frequently advised.
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Penile injections are used for local delivery, and to reduce the pain, local anesthesia is also administered along with the drug.
What Are the Surgical Approaches for Treating Penile Curvature Disorder?
Following are a few common surgical approaches for treating penile curvature disorder:
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Grafting is the most commonly practiced surgical approach for treating penile curvature. In this type of surgical treatment, the urologist will remove the plaque or the flat scar tissue in the penis. This technique also helps restore the size of the penis that was shortened due to penile curvature.
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Plication is the technique done in cases where the angulation of the penis is high, and the presence of plaque or scar tissue is more. The only drawback of this surgical approach is that the normal size of the penis cannot be restored by performing this surgical method.
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Implantation is the latest surgical approach used for treating penile curvature disorder. In this technique, the doctor will insert an implant inside the penis that will assist in penis erection. In a few cases, the implant is placed after surgical approaches like grafting or plication correct the penile curvature.
Conclusion:
Penile curvature is an abnormal bend in the penis that occurs during erection. It is noted to be a complex problem for pediatric urologists. Peyronies's disease begins after forming a flat small scar tissue within the penis. This scar tissue is not a tumor but may lead to complications such as penile curvature disorder or, in a few cases, painful erection. Many surgical approaches have been planned to treat penile curvature, but various procedures are also associated with a few complications.
