Chordee (Penile Curvation)

Penile curvature, or chordee, is a congenital penile condition where the penis bends abnormally when erect. Curvature when the penis is not erect is normal. This can occur with or without hypospadias, which is when the urethral opening is not at the tip of the penis. Hypospadias occurs in 0.33% of male births, of which 25% will have penile curvature.¹ Similarly, penile curvature can occur in the presence of penile torsion. Curvature is most often in a downward direction but can be to the side. Chordee is a congenital abnormality not the same as Peyrone’s disease, which has different causes and treatments.

Symptoms

  • Visible curvature of the penis.
  • Difficulty with urination (often associated with hypospadias).
  • There is potential for sexual dysfunction later in life.

Diagnosis

Diagnosis of penile curvature begins with a medical history and physical examination by your doctor. Any curvature greater than 20-25 degrees is considered significant and requires correction.1

Treatment

Treatment of penile curvation depends on the severity of the curvature and the presence of hypospadias (if present). Not all cases of penile curvature require surgical treatment. Generally, chordee correction is less complicated when addressed before puberty as curvature can become more exaggerated after puberty.

Conservative Management

Mild cases are monitored for an increase in symptoms or curvature.

Surgical Intervention

Dorsal plication is often performed on mild to moderate curvatures. This is a procedure that uses a suture to counterbalance and thus straighten the penis.

Ventral corporal incision and grafting are performed on severe curvature; this procedure lengthens the shorter side to straighten the penis but is only performed in the setting of severe hypospadias

Follow-Up

Your child will need regular check-ups with their doctor to monitor the progress of the curvature, healing following surgery, and outcomes of surgical intervention.

Resource:

  1. Moscardi PRM, Gosalbez R, Castellan MA. Management of High-Grade Penile Curvature Associated With Hypospadias in Children. Frontiers in Pediatrics. 2017;5. doi:https://doi.org/10.3389/fped.2017.00189