Acquired penile curvature (IPP) is a condition that usually results from vigorous sexual intercourse in which the penis is severely bent or kinked. This causes minute injuries to the tissues, which harden over time and cause penile curvature. IPP should be distinguished from congenital penile curvature.
What is penile curvature?
With the term penile curvature, as already indicated, one must distinguish between congenital and acquired penile curvature. The congenital form is understood to be an altered penile shape already existing at birth, which often results from an asymmetrical development of the penile tissue. Acquired penile curvature, which is described below, usually occurs around the age of 50. It is also called induratio penis plastica (IPP) in medical terminology, which means “deformation of the penis due to hardening”. In the past, penile curvature was also called Peyronie’s disease, after the French surgeon de la Peyronie, who first described the condition in the mid-18th century. In penile curvature, pathological indurations form in the penile tissue, but they are benign. They cause the curvature of the penis, usually visible only during erection.
Causes
Acquired penile curvature is caused by hardenings in the penile tissue. However, what causes these changes is not yet fully understood. It is thought that injuries to the penile tissue are the main cause. They can occur during sexual intercourse when the penis is bent or even kinked in an erect state. This can cause tears in the erectile tissue sheath, but they are so small that they are usually not noticed. Normally these injuries heal without problems, but in some men connective tissue lodges in the tears and can be felt through the skin as small nodules. Over time, these nodules harden and cause the curvature. The reason why the cracks heal in some men and the nodules form in others is thought to be a disorder of the connective tissue metabolism. Genetic predispositions are considered another possible cause of penile curvature, but no exact facts have been researched yet.
Symptoms, complaints and signs
The symptoms of penile curvature turn out differently. This depends on whether it is a congenital or an acquired penile curvature. In acquired penile curvature, palpable and sometimes visible plaques form. These consist of hardenings on the shaft of the penis and form over a period of several weeks and months. These indurations can grow up to three centimeters in size and can occur anywhere on the shaft. They are more common on the upper side than on the lower side of the member. Fibrosis occurs as a result of the proliferating and hardening connective tissue. The limb bends in the direction of the hardening and thus usually upward. The extent of the curvature can vary greatly and it can also happen that the limb bends in several directions. This can cause erection problems and pain during sexual intercourse. In addition, the plaques can lead to decreased blood flow, making the erection less hard toward the glans. Sufferers of penile curvature experience limitations in their sex life due to the altered member. Rarely, the plaques cause nerve damage and loss of sensation to the member (especially the glans). Congenital penile curvature, on the other hand, brings few symptoms. The main symptom is a curved – but usually completely functional – penis. Restrictions in sexual life occur here only in very severe curvatures.
Diagnosis and course
The symptoms of acquired penile curvature vary. In some affected individuals, the curvature appears suddenly; in others, it develops gradually. Pain may occur, especially during sexual intercourse, but penile curvature also remains completely painless in some patients. The connective tissue hardening usually occurs on the top of the penile shaft, but it can form in other places as well. Due to the hardening, the erectile tissue skin can no longer adapt to the erect shape of the penis. It shortens in the place where the nodules are located and a bend develops.The larger the lumps are, the more the penis curves. If the indurations occur on two opposite sides, the penis may be constricted. If several nodules have formed in different places, this can lead to a shortening of the penis. Erection problems may also develop. To make a diagnosis, the doctor asks about the medical history and symptoms and palpates the penis for existing nodules. Ultrasound, magnetic resonance imaging (MRI) and X-rays can be used to visualize the connective tissue deposits that occur with penile curvature and any inflammation that may be present.
Complications
Complications associated with penile curvature can be psychological and physical. Since penile curvature may be stressful for the affected person, he or she may develop a negative self-image. Depression or general moods can follow and have consequences if the condition persists for a long time. These may include, for example, drug use and self-injurious behavior. Social stress can also be triggered. An unsatisfactory or non-existent sex life due to penile curvature exacerbates these effects. In addition, a relationship suffers as a result. Further complications can arise from unqualified, supposed self-help measures. Devices or medications used to supposedly straighten the member can, at most, lead to poisoning or serious injury. Physical attempts on the part of the affected person to straighten the penis are particularly dangerous. In the worst case, this leads to a rupture of the corpus cavernosum, a painful skin injury or similar. Complications can also arise from the surgical treatment of penile curvature. In about ten percent of cases, erectile dysfunction occurs afterwards. The susceptibility to infection is also temporarily greatly increased after such an operation. Scars, bleeding and inflammation are possible. Therefore, surgery should be carefully considered and should only be performed if absolutely necessary.
When should you go to the doctor?
Penile curvature is a reason to see a doctor only under certain circumstances. For example, in the case of congenital penile deviation, it does not require treatment as long as the member is perceived as functional and an acceptable sex life can be experienced. In this regard, the curvature is perceived very subjectively by affected men and is often considered an aesthetic problem. In fact, however, most congenital penile curvatures are not serious enough to cause discomfort. An acquired – i.e. later occurring – penile deviation, on the other hand, is a reason to visit the doctor. This is less about the curvature itself than about the possible background. There are several diseases (for example, plaque formation, diabetes) that can cause curvature of the limb. Severe changes of the limb are basically a reason to consult a urologist. In addition, a urologist should also be consulted if sexual sensation suffers from the curvature. Depending on the person, this can be the case with very different degrees of curvature. There are men who have no complaints at all despite pronounced curvature of their member and those who have complaints due to the change in shape. If, in addition, one’s own member is a burden on the psyche because it is perceived as “unattractive” or “repulsive”, talk therapy can help. This is especially true if the penile curvature is not a problem medically.
Treatment and therapy
To date, there is no known curative therapy for acquired penile curvature. However, treatments are available that alleviate symptoms and favorably affect the course of penile curvature. For example, medications are prescribed to be taken that have anti-inflammatory and anti-scarring effects, such as vitamin E or colchicine. In addition, creams and gels can be applied directly to the penis. Cortisone or interferon injections into the penile shaft at the affected areas are also used for treatment. However, this method is controversial because, in addition to the healing effect of the injection, further injury to the penile tissue with renewed scarring is possible due to the placement of the needle. Another treatment option is extracorporeal shock wave therapy (ESWT), in which the hardened connective tissue nodules are shattered by shock waves.After the acute phase has subsided, in which the injuries are still fresh and inflammations are still present, a surgical procedure can be performed. In this case, the hardening caused by the curvature of the penis is removed.
Outlook and prognosis
The prognosis and further outlook in case of penile curvature is tied to the present cause. In the case of a congenital health impairment, no spontaneous healing or relief of symptoms can be expected without medical care. The tissue of the penis is damaged from birth and therefore developed asymmetrically. There may be changes in the developmental process and thus a decrease in irregularity. Nevertheless, recovery is not achieved in most men. There is a genetic defect that cannot be changed with the current scientific and legal possibilities. In particularly severe cases, surgical intervention is performed. This is to change existing tissue abnormalities. The aim of the treatment is to optimize health complaints. If the affected person suffers from tissue injuries due to an accident or other damage, the healing process can lead to an alleviation of the complaints. Nevertheless, full recovery is often not achieved. Erectile dysfunction or pain in the genital area may develop in the long term. In addition, the risk of inflammation is increased. With medical care, there are therapy options that lead to an improvement of the overall situation. Nevertheless, freedom from symptoms is not always achieved. Basically, psychological secondary disorders are to be expected with this disease, since a strong emotional state of stress prevails.
Prevention
There is no specific prevention against penile curvature. Since the condition is mainly caused by vigorous sexual intercourse and by sexual practices in which the penis bends or kinks severely, one should refrain from this type of sexual intercourse to avoid penile curvature.
Aftercare
The purpose of follow-up care is, among other things, to prevent the recurrence of the condition or at least to detect it early. However, this may not be determinant in the case of penile deformity. This is because either the malposition of the male member persists or it could be treated successfully. In the latter case, no further follow-up is necessary. The patient can go on with his life. If, on the other hand, a therapy could not lead to success or if such a therapy was waived, the patient has to cope with restrictions in everyday life. In addition to possible physical complaints resulting from surgery, it is usually the psychological suffering that weighs the heaviest. Many of those affected have a diminished sense of self-worth, which can lead to depression. Therefore, aftercare often consists of long-term psychotherapy. Since sexuality takes place in the intimate and familiar sphere, openness to the respective sexual partner is essential. Therapy can convey how a fulfilling sexuality is possible in view of the curvature of the penis. However, the implementation of such a partnerly act of love then falls within the area of responsibility of the person affected. Scheduled follow-up examinations over a period of years, as is the case with cancer, are not provided in the case of penile curvature. Patients should consult their physician in case of acute problems. There is no life-threatening situation.
Here’s what you can do yourself
The options for self-help in the case of penile deviation are limited and have no bearing on the cause of the deviation. Thus, it should be noted that the need for self-help measures should be made dependent on the degree of penile curvature. While a curvature that still allows for an intact sexual life does not necessarily require treatment, a severe curvature may. Since far from medical treatment (and surgery) there are hardly any options for the treatment of penile deviation, various products are offered that supposedly take care of it. However, the use of penis pumps, stretching devices and other utensils that promise to straighten the member is strongly discouraged. The risk of injury is too high and a (lasting) effect is not to be expected. In the case of a curvature of the penis, the affected person basically only has the options of coming to terms with his condition – and if necessary adapting his sex life accordingly – or seeking medical treatment.If erections or stimuli on the member are associated with mild pain, learned relaxation techniques may provide relief. In fact, the best way to help yourself is to get clarity about how limiting the penile deviation is – and whether it might be better to seek medical help.
