Congenital penile curvature, also commonly referred to as “crooked penis,” is a condition seen in male children from birth. If left untreated, it can lead to significant sexual and psychological issues later in life. In this article, I will provide general information based on my experience monitoring and treating many cases of congenital penile curvature.

What is congenital penile curvature?

Congenital penile curvature, also known as chordee (penile curvature, penile deviation), is a curvature of the penis present from birth without any external cause (such as trauma or disease). Families often notice it while changing diapers or dressing their child. Sometimes, it may go unnoticed until puberty, when the curvature becomes visible during an erection.

How common is congenital penile curvature?

Exact statistics are hard to determine, but it is estimated to occur in about 1 out of every 100 male births. The degree of curvature can vary.

Is i0t hereditary?

There is limited information, but some studies suggest it may be hereditary. There are documented cases of two brothers both having penile curvature corrected through surgery.

What are the symptoms?

Symptoms of congenital penile curvature may be physical or psychosocial. There is usually no pain during erection or intercourse. Common symptoms include:

• Penile curvature during erection
• Deformity of the penis when erect
• Pain during intercourse in some cases
• Partner may also feel pain during intercourse
• Difficulty during sexual activity
• Inability to have intercourse if curvature is severe
• Erection problems in serious cases
• Penile shortening
• Twisting of penile skin or rotation (torsion)
• Decreased self-confidence
• Feelings of embarrassment during intercourse

How is curvature classified?

Curvature is classified by degree:

• Mild curvature: Less than 30 degrees
• Moderate curvature: Between 30 and 60 degrees
• Severe curvature: Greater than 60 degrees

Is a slight curvature normal?   

Mild curvatures are considered normal. It is common for the penis to curve slightly in various directions during erection. However, if the curvature is severe enough to interfere with intercourse or cause psychological distress, it is not considered normal and should be evaluated by a urologist.

What causes congenital penile curvature?

The exact causes are unknown, but two main factors are considered:

1. Defect in the tunica albuginea: This layer surrounds the erectile tissues of the penis. Uneven growth can cause curvature toward the underdeveloped side.
2. Hypospadias: A condition where the urethra opens on the underside of the penis, often accompanied by downward curvature.

Is ıt permanent?

Yes, congenital penile curvature is permanent and does not resolve on its own. Surgical correction is required.

How is ıt treated?

Surgery is the only treatment. The penis is surgically corrected to restore a normal shape.

Can ıt be corrected naturally?

No. There is no natural treatment for this condition. Medications, herbs, or alternative therapies are not effective.

Can these patients have children?

Yes. The testicles are normal, and there is no issue with sperm production. As long as they can have intercourse, fertility should not be affected. If intercourse is not possible, medical evaluation is needed.

Is it harmful?

While not a serious physical health threat, it can cause psychological distress, reduce self-confidence, and lead to erectile problems, making treatment important.

Does ıt affect sexual function?

Depending on the severity, it can cause:

• Psychological issues for both partners
• Pain during intercourse
• Risk of penile fracture due to strain

Is it a serious problem?

The curvature is only noticeable during erection. While not dangerous, it may cause significant psychological and sexual difficulties if severe.

Does İt progress over time?

No. The condition is stable and does not worsen over time. There is no need for preventive treatment or medication.

Can it improve on its own?

No. Spontaneous correction does not occur. Surgery is necessary.

Is there a non-surgical treatment?

No. There is no effective non-surgical treatment. Only surgery can correct the curvature.

When should surgery be done?

Ideally after age 18, when penile growth is complete. In severe cases or if the appearance causes distress, earlier surgery may be performed. Surgery is also recommended if hypospadias is present.

When is surgery recommended?

• Curvature exceeds 30 degrees (especially >60 degrees)
• Difficulty with intercourse
• Partner experiences pain during intercourse
• Psychological discomfort
• Dissatisfaction with appearance

ıs there penile shortening after surgery?

Yes, especially with the plicational technique. The more severe the curvature, the more shortening may occur. In severe cases, techniques are used to preserve length, and the penis may even appear longer post-surgery.

can the curvature recur after surgery?

No, not if the surgery is done properly. The penis retains its corrected shape.

Is ESWT Effective?

No. ESWT (shockwave therapy) is used for Peyronie’s disease, which involves pain and plaque. Congenital curvature has no plaque or pain, so ESWT is not effective.

How to distinguish from peyronie’s disease?

Pre-surgery preparation

• Stop blood thinners 5–6 days prior
• Inform anesthesiologist of chronic medications
• Chest X-ray and ECG may be required
• Routine blood tests are conducted

On surgery day

• No food/drink 4–5 hours prior
• Arrive 1–2 hours before surgery
• Informed consent is obtained

Post-surgery care

• Usually discharged the next day
• Antibiotics and pain relievers prescribed
• Avoid strenuous activity for 4 weeks
• Wear comfortable clothing
• Stitches dissolve on their own
• Avoid water contact on wound for a week
• Sexual activity can resume in 4–6 weeks
• Follow-up as recommended

Surgery duration

Takes 1–2 hours depending on the procedure.

Hospital stay

Discharged same day or next day.

Type of anesthesia

Spinal (lower body) or general anesthesia. General is preferred for children.

Complications

Rare if performed by experienced surgeons. Temporary numbness or skin tightness may occur.

Surgical options

1. Plication Surgery: Sutures are placed on the opposite (normal) side to balance curvature. May cause slight shortening depending on severity.
2. Graft (Patch) Surgery: Tissue is removed from the curved side and replaced with a graft. Prevents shortening but requires more skill and time.

Summary

Congenital penile curvature is a birth defect characterized by penile curvature and deformity. If untreated, it can cause serious psychological distress. There is no non-surgical cure. Surgery is highly effective with a near 100% success rate when performed by experienced hands, and complications are rare.

Prof. Dr. Emin ÖZBEK
Urology Specialist

Istanbul- TURKIYE