Childhood penile curvatures (curvatures) are congenital. It arises from an abnormality in the development of the penis in the womb. Its incidence is 2 per 1000 live births. It is mostly associated with hypospadias (urinary hole being lower than normal) disease. It is detected earlier when it is associated with hypospadias. Penile curvatures without hypospadias are more difficult to notice, this disease is called “chordee without hypospadias”. These may not be noticed until adulthood.
Most curvatures are mild and clinically insignificant. 50% of them are ventral (forward), 25% lateral (right or left, left more often) curvature, 20% forward and sideways together, and 5% dorsal (backward) curvature. These patients usually begin to notice the curvature of the penis during erection when they reach puberty. The degree of curvature is very important. Penile curvatures up to about 30 degrees are usually asymptomatic and may not need to be treated. However, curvatures of more than 30 degrees can cause difficulty in sexual intercourse and pain during sexual intercourse. In patients with severe curvature, penile fractures can be seen during sexual intercourse, as well as psychological discomfort in the patient. Although some patients have a low degree of curvature, they only consult a doctor for cosmetic reasons. Photograph taken while the penis is hardened so that you can see the curvature from the full side is very important in the diagnosis.
In the surgery, the root of the penis is suffocated with a rubber, the skin of the penis is cut from the circumcision line and peeled to the root. Then, the penis is erected artificially and the location and severity of the curvature are determined. Again, various surgical techniques can be applied depending on the location and severity of the curvature. The most commonly used method is bending sutures into the erectile tissue in the opposite direction of the curvature. However, if necessary, tissues (skin, veins) to be taken from other parts of the body can also be used. After the necessary procedures are performed, it is checked whether the curvature is corrected or not. If the desired improvement is achieved, circumcision is performed if the patient is uncircumcised, and if circumcised, the penile skin is properly closed and the procedure is terminated. In patients with severe chordee (severe curvature) and a short urethra, the urethra may need to be cut in half. In this case, it may be necessary to take tissue from different parts of the body (arm or thigh skin, mouth, bladder, fascia in the scrotum) for the normal fulfillment of the urination hole. If possible, a new urethral canal is created and a urethral catheter is placed and the operation is completed. In cases where the tissue needs to mature or the mouth of the canal is too far from the normal place, the tissue taken is placed on the penis and maturation is expected, while the actual correction process can be postponed to a later date (about 6 months later). The success rate of the surgery is approximately 90%.
