Congenital Penile Curvature (CPC) is a condition that appears in males at birth and becomes more prominent during erection, progressing to its peak during adolescence.

The curvature can be dorsal (upward), ventral (downward), lateral (to the left or right), or biplanar.

The degree of curvature can be determined when the penis is erect. The prevalence of congenital penile curvatures reaches about 0.6% or six men per thousand.

How does congenital penile curvature differ from Peyronie’s disease?

Peyronie’s disease involves acquired curvature and has not been present since birth. It also involves scar tissue on the penis. On the other hand, congenital penile curvature is a condition present at birth in males and does not involve scar tissues. Over time, Peyronie’s disease may worsen and penile curvature may increase.

Peyronie’s disease and congenital penile curvatures are two different conditions and are treated differently. To learn more about acquired penile curvature or Peyronie’s disease, click here.

What are the causes of congenital penile curvature?

The causes of congenital penile curvature are unknown, but it is believed to occur due to uneven growth between the opposing sides of the penis.

Does congenital penile curvature affect marital relationships?

In some cases, penile curvature may be mild and not cause any problems. However, in other cases, significant curvature can cause pain or difficulty with penetration and intercourse, affecting the sexual relationship and subsequently the sexual desire of both partners.

Men may experience anxiety or embarrassment due to the appearance of their penis, which can affect their self-confidence and desire to engage in sexual activity.

Additionally, couples may struggle to find comfortable and suitable positions during intercourse, which can impact their overall desire for intimacy.

In cases where congenital penile curvature significantly affects the marital relationship, it is advised to consult a specialist in reproductive and sexual medicine. Professor Dr. Adham Zaazaa, MD, Consultant in Andrology, can evaluate the condition and provide appropriate treatment.

How is congenital penile curvature diagnosed?

Congenital penile curvature can be naturally present to some extent, either to the right or left. The diagnosis of congenital penile curvature is usually made when the penis is erect. It is often discovered by the parents during diaper changes or clothes changes. In other cases, males may become aware of the curvature themselves during adolescence.

Congenital penile curvature cannot be diagnosed based on the appearance of the flaccid penis. Furthermore, a man with a slight curvature to the right or left is not diagnosed with congenital penile curvature as long as it does not hinder him from engaging in sexual intercourse normally.

What are the accompanying symptoms of congenital penile curvature?

Common symptoms experienced by individuals with congenital penile curvature, with a curvature angle of more than 30 degrees, can be physical or psychological.

Physical symptoms may include:
• Penile curvature.
• Difficulty in achieving and maintaining an erection.
• Painful erections.
• Pain or difficulty during sexual intercourse.

Psychological symptoms may include:
• Decreased self-confidence.
• Feelings of shame during sexual activity.
• Embarrassment due to the abnormal appearance of the penis.

How is congenital penile curvature treated?

Treatment is not necessary unless the condition interferes with sexual life or prevents satisfactory intercourse for both partners. In such cases, surgery is usually considered to correct the curvature.

The goals of surgical correction of penile curvature are:
• Straightening the penis.
• Minimizing any loss of penile length.
• Reducing the likelihood of minor complications, such as hematoma or decreased penile sensitivity.

Cases that require treatment may include:
• Severe curvature that interferes with intercourse, exceeding 30 degrees.
• Emotional distress and psychological pressure, especially during adolescence, despite the mild curvature.
• Pain and discomfort during intercourse for the man or his wife.

Techniques for correcting penile curvature:

1. Plication Technique (16-Dot Technique):
The plication technique aims to shorten the longer side of the penis by applying permanent corrective sutures in the opposite direction of the curvature.

The 16-Dot Technique involves aesthetically placing sutures in the longer part of the penis to adjust it until it becomes completely straight, similar to the opposite side. The surgery takes about an hour, and the patient can return home on the same day and have sexual intercourse after 4 or 6 weeks.

However, this technique has had some complications, the most significant of which is the presence of permanent visible knots at the suture site.

2. Incision Technique:
The incision technique involves opening the shorter part of the penis and patching the gap with a portion of the patient’s tissue. This may lead to a decrease in penile sensitivity and a 30% risk of erectile dysfunction in some cases, limiting its use despite its ability to maintain penile length.

For these reasons, Professor Dr. Adham Zaazaa, Consultant in Andrology and Reproductive Medicine and Surgery at the Faculty of Medicine, Cairo University, sought to improve the penile correction technique by combining the plication and incision techniques without opening the cavernous tissues, aiming to achieve the advantages and avoid the drawbacks of both techniques.

3. Combined Plication-Incision Technique (CPI):
This new technique, developed by Dr. Adham Zaazaa and published in specialized scientific journals on male surgeries, is one of the plication techniques without opening the cavernous tissues. It offers the following advantages:
• The CPI technique avoids the cavernous tissue incision that occurs in the incision technique, preserving erectile firmness after surgery.
• The CPI technique is equivalent to the 16-Dot Technique in terms of its ability to correct penile curvature and maintain erection.
• The CPI technique has fewer post-surgical complications, penile shortening, and the risk of recurrent penile curvature compared to the 16-Dot Technique.
• The CPI technique eliminates bothersome knots by burying non-absorbable sutures used in the 16-Dot Technique in a way that makes them less noticeable.

Is CPI suitable for all cases, and when is the 16-Dot Technique preferred over CPI?

The CPI technique is superior to the 16-Dot Technique for cases that require better burying of sutures to maintain a more natural penile texture after surgery.

The first step to successful treatment is selecting the appropriate candidate for surgery and the most suitable surgical technique for the patient. With the extensive experience of Dr. Adham Zaazaa, Consultant in Andrology and ICSI and Professor of Andrology and Fertility Surgery at Cairo University, you can ensure all modern surgical options for penile curvature correction. He guides his patients to the treatment that guarantees the best possible results for each, based on their specific medical requirements.