The diagnosis of congenital penile curvature is based on history taking and on the examination of the patient. Most patients notice the curvature during adolescence. Examination of the penis will demonstrate a soft, elastic tunica albuginea and the absence of the indurated lumps typical of Peyronie’s Disease.
Deformity can be assessed only during erections, when the tunica albuginea of the penis is stretched to its maximum capacity. Self-photography of the erect penis can be a useful tool to identify the nature of the deformity. However, this can underestimate the exact tridimensional extent of the curvature, as the picture is by definition bi-planar. Also, an incomplete erection will make the deformity appear less pronounced. Alternatively, an artificial erection can be induced in the office with the administration of a vasoactive medication. This allows the surgeon to assess more precisely the tridimensional extent of the curvature and better plan the treatment options. Doppler ultrasound scan can be extremely useful to rule out the presence of plaques in the equivocal cases.
In patients with congenital ventral penile curvature it is very important to examine the urethral meatus and the distal urethra as congenital ventral penile curvature may be associated with anomalies of the penile urethra.