Correction of Curved Penis

Penile curvature is a common problem, where the erect penis is bent to a side. When the bend is more than thirty degrees, it commonly prevents a normal sexual relationship and causes pain in the female partner, despite good erection. Surgery is necessary in such cases.

The penis may be bent or curved due to inborn congenital abnormalities or an acquired fibrotic disorder. Fibrosis is the deposition of inelastic tissues, usually to rebuild and bridge a gap at the site of injury.

Fibrous tissue in the penis leads to shortening, curvature and loss of erection in some cases, being inelastic and being deposited where blood should flow to fill up the penis.

Fibrosis may occur in the penis due to a disease named "Peyronie's disease" the cause of which is not known, but is commonly attributed to diabetes and rough sexual intercourse.

Fibrosis may also occur following prolonged untreated priapism, or due to repeated injection of the penis to induce erection in cases of impotence (intra corporal injection), irradiation for treatment of cancer, among other causes.

Surgical treatment of curvature usually causes shortening of penis. This is because the classic techniques rely on shortening the longer side of the penis. To understand this concept, refer to the diagram herein that shows a curved penis with a shorter lower border and a longer upper border. Whatever the direction of curvature is, there is always a longer side and a shorter side. Surgery relies on shortening the longer side.

An alternative is elongation of the shorted side by inserting tissues into this aspect of the penis to widen it (grafting). Unfortunately, this causes impotence in many cases.

The author of this website; Dr.Shaeer invented a surgical technique that can correct some cases of curvature without shortening:

Correction Of Penile Curvature By Rotation Of The Corpora Cavernosa: A Case Report
O.K.Z. Shaeer
JSM, DOI: 10.1111/j.1743-6109.2006.00203.x
 

This technique relies on a unique geometrical idea where rotation of the corpora cavernosa results in transferring the shorter curve to the inside of the penis, correcting the curve without shortening (refer to the illustration below).

 

On the other hand, in cases of extreme fibrosis of the penis, or when there is associated severe impotence, the only solution is insertion of a penile prosthesis. Unfortunately, insertion of a penile prosthesis in such conditions is very difficult and risky since the rigid fibrous tissue occupies the corpora cavernosa, where the prosthesis should be inserted. The corpora cavernosa are closed cylinders. Removal of fibrous tissue out of them is usually done by excavation in blind fashion ( being closed cylinders), unless a very long incision is performed spanning the whole length of the penis. Blind excavation results in  severe injuries. Long incisions result in infections. Again, the author of this website; Dr.Shaeer, has designed an innovative surgical technique where an endoscope is inserted into the corpora cavernosa, allowing easy excavation under vision. This technique is internationally published under the name of "Shaeer's Technique":

Corporoscopic Excavation of the Fibrosed Corpora Cavernosa for Penile Prosethesis Implantation: Optical Corporotomy and Trans-Corporeal Resection, Shaeer’s Technique.
Osama Shaeer and Ahmed Shaeer. DOI:10.1111/j.17436109.2006.00348.x