From this point of view, congenital penile curvature is quite similar to acquired penile curvature or Peyronie's Disease, as in both cases there is a convex, longer and a concave, shorter aspect of the shaft penis. However, in case of congenital penile curvature, the asymmetry is due to an uneven development of the chambers of the penis while in Peyronie's Disease the scarring associated with the plaque causes shortening of one aspect of the penile shaft.

Congenital penile curvature usually becomes apparent during adolescence, when the chambers of the penis develop at the highest pace.

Fortunately, most of the congenital penile curvatures are minor and do not interfere with penetrative sexual intercourse. Only a minority of congenital curvatures are so severe to require surgical correction.

Although congenital penile curvature may point virtually in any direction, in most cases the penis bends downward; in this case the curvature is called ventral. Ventral curvatures may present in isolation or together with anomalies of the penile urethra (the waterpipe).

Our Uro-Andrology department is led by Mr. Giulio Garaffa, an award-winning Consultant Uro-Andrologist with over 20 years’ international medical experience in this field. Mr Garaffa has a global reputation for his excellence in urology and andrology, and is one of the leading experts in the fields of erectile dysfunction, congenital penile curvature, complex penile reconstruction, phalloplasty, Peyronie’s disease, male infertility and microsurgery.

Frequently Asked Questions

A congenital penile curvature is caused by an uneven development of the two chambers that form the penis. This ultimately causes the erect penis to bend towards the aspect that has developed less.From this point of view, congenital penile curvature is quite similar to acquired penile curvature or Peyronie’s Disease, as in both cases there is a convex, longer and a concave, shorter aspect of the shaft penis. However, in case of congenital penile curvature, the asymmetry is due to an uneven development of the chambers of the penis while in Peyronie’s Disease the scarring associated with the plaque causes shortening of one aspect of the penile shaft.Congenital penile curvature usually becomes apparent during adolescence, when the chambers of the penis develop at the highest pace. Fortunately, most of the congenital penile curvatures are minor and do not interfere with penetrative sexual intercourse. Only a minority of congenital curvatures are so severe to require surgical correction.

Although congenital penile curvature may point virtually in any direction, in most cases the penis bends downward; in this case the curvature is called ventral. Ventral curvatures may present in isolation or together with anomalies of the penile urethra (the waterpipe). In congenital penile curvature the deformity can render penetrative sexual intercourse difficult or impossible and therefore can be cause of embarrassment and distress.

Both Peyronie’s Disease and congenital penile curvature can be found in adolescents and young adults and therefore the age of onset is not a good criterion to distinguish between the two conditions. However, in patients with congenital penile curvature there is no palpable lump, which is instead indicative of Peyronie’s Disease.  Also, while most congenital curvatures are ventral, in most patients with Peyronie’s Disease the penis bends upward. Waist deformities are also absent in patients with congenital curvature, which tend to be more gentle and harmonic than the one of patients with Peyronie’s Disease.>

While erectile dysfunction is a common finding in patients with Peyronie’s Disease, most patients with congenital penile curvature have adequate erections, as there is no association between cardiovascular risk factors and congenital penile curvature. To render the situation more confusing, some of the patients with congenital penile curvature may eventually develop Peyronie’s Disease later in life and therefore both conditions may coexist

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.

There is no effective medical treatment for congenital penile curvature as there is no scarred tissue to target. Therefore the only solution is surgery.

Surgical correction consists in the shortening of the longer, convex aspect of the shaft to make it even with the shorter, concave aspect. This is called tunica albuginea plication (TAP) or Nesbit procedure. Incision of the shorter side and grafting should not be offered as it gives poor results in patients with congenital penile curvature. This is because the curvature is more harmonic and not localized as in patients with Peyronie’s Disease. Fortunately, most patients with congenital penile curvature have an adequate penile size and therefore plication surgery will not cause excessive shortening. Straightening procedures are performed under general anaesthetic as a day case, are very reliable and safe in the hands of experienced, large volume surgeons like Mr Garaffa and patients can usually resume sexual activity four to six weeks afterwards

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What to expect

Free Consultation with one of our Patient Advisors

We offer a free, no-obligation 30-60 minute consultation with one of our Patient Advisors. They will work with you to understand your objectives and the results you want to achieve, talk you through the procedure and answer any questions you may have. If you decide that you would like to proceed to the next step and see a surgeon, your Patient Advisor will be happy to arrange this for you. At this point, you will be required to pay a consultation fee. 

Surgical Consultation

The next step is for you to meet your chosen surgeon at the Cadogan Clinic. Your surgeon will use this time to make a comprehensive medical assessment of you, your condition, and your expectations before making a recommendation and personalised treatment plan for you. You will then discuss the outcomes you can expect to see and ask any questions.

The Procedure

On the day of your procedure you will be welcomed at the Cadogan Clinic by your Patient Advisor and dedicated nursing staff. Following a brief medical check, you will meet with both your surgeon and anaesthetist to run through the details of your procedure one final time and answer any last questions you may have.  

Recovery

After the procedure, you will recover in the capable hands of our aftercare team. As we are a day-case facility you can expect your recovery to be complete within 2 to 3 hours. If your surgeon is happy with your results, you will be able to be discharged from the Clinic the very same day. In some cases patients may wish to stay locally in our exclusive partner hotel the day before or after your procedure in order to be close to their surgeon. Talk to us about these options if this is for you. 

After Care & Support

Our care and support continues in the days and weeks following your procedure with our complimentary aftercare programme. This comprised of a series of appointments made with your surgeon and nursing team to monitor your progress and recovery. They will also introduce you to several scar minimization techniques and bespoke products to aid your progress. Our team are also on call to answer any questions you have around your surgery at any time you are concerned.

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Mr. Giulio Garaffa
Mr. Giulio Garaffa

Uro-Andrologist

Considered one of the world leading experts in his fields of interest and is invited world wide to give lectures and perform live surgery