Congenital Penile Chordee

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Congenital penile chordee is a relatively common condition in which the head of the penis curves when the penis is in an erect state. The disorder is frequently seen with hypospadias, another congenital condition that occurs when the penile opening forms in a location other than at the tip of the penis. When the two exist together, penile chordee is often detected in infancy and repair can performed at a very young age.

However, chordee is frequently not noted until a man reaches sexual maturity and discovers the significant curvature of the erect penis. While the condition itself is not typically painful, it can cause discomfort for both a man and his partner during intercourse. In severe cases, a man may not be able to achieve a sufficient erection for intercourse when chordee is present. Fortunately, repair is also relatively straightforward and in a vast majority of cases successful on adult patients as well.

Penile Chordee Overview

A penis with penile chordee will appear to have too much elasticity on one section compared to the rest of the penis. If hypospadias is also present, the irregular opening of the penis may make it impossible to urinate in a standing position. Other symptoms of penile chordee might include the following:

Penile Torsion

Some people with chordee have a midline raph (the ridge that usually extends down the length of the underside of the penis) that wraps around the penis instead. This wrapping effect can pull the penis downward, resulting in a curvature.

Webbing

Webbing can occur between the penis and the scrotum, a condition known as penoscrotal webbing. When this symptom is present, it can be even more difficult for a man to achieve an erection sufficient for intercourse. The appearance of the penis can also be significantly different, leading to loss of self-esteem for many men.

Skin Tethering

In some cases, the skin around the urethra can also be extremely thin. This problem can be repaired surgically at the same time as the chordee repair to ensure proper protection and full function of the urethra.

Dorsal Preputial Hood

This symptom is characterized by insufficient foreskin – the skin that typically wraps around the tip of the penis. With a dorsal preputial hood, only half of the tip is covered. Grafting may be needed at the time of the chordee repair to produce sufficient skin to normalize the appearance of the penis.

A consultation with Professor Moore is the best way to evaluate congenital penile chordee and determine whether the curvature requires surgical treatment. If so, the procedure is generally performed as day surgery.

Causes of Congenital Penile Chordee

There is no known cause of congenital penile chordee. It typically occurs while the baby is developing in the womb and is present at birth, which is why it is referred to as a congenital condition. While the penis commonly curves downward, the curvature can form in any direction: up, down, left or right. Because chordee does not involve any pain or scarring in childhood, the condition may go undetected for some time. It is not typically associated with an injury or penile shortening. It may have a genetic component, as it does seem to run in families. Performing circumcision while the penis is inflamed may also lead to a curvature similar to chordee, typically due to scar tissue forming that pulls the penis downward.

The Psychological Impact of Penile Chordee

While penile chordee is not usually physically painful, it can have a significant impact on a man’s self-esteem and his intimate relationships. A man might be self-conscious about his appearance, which could affect his sexual performance. If the curvature does cause discomfort for a man or his partner, this can also negatively impact his relationships. Additional symptoms like penoscrotal webbing can further exacerbate the situation.

Treatment Options

Surgical correction of congenital penile chordee is often recommended for men that have a substantial curvature that is impacting their quality of life or their intimate relationships. Surgery can be performed as a day procedure, using either local or general anesthesia to ensure your comfort throughout. Professor Moore will remove excess tissue from one area and graft in tissue to another if necessary to ensure the penis is the same length on all sides. If hypospadias is present, the urethra can also be redirected to the tip of the penis and a new opening created at this time. Once the correction is made, Professor Moore will inject the penis with a sterile saline solution to ensure the curvature is completely repaired.

After the surgery, the penis will be wrapped in a surgical dressing to protect it as it heals. A catheter may be used for urinating for the first few days to avoid possible infection or other complications. Most men are back to their regular activities within a week. Professor Moore will advise you as to when you can resume strenuous exercise and intercourse.

If you are self-conscious about your appearance or experiencing discomfort during intercourse due to a curved penis, surgical help may be available. Contact the Australian Centre for Cosmetic and Genital Surgery today on 0414 251 234 to find out if correction for penile chordee is the right option for you.

Prof Colin Moore