Congenital penile curvature is relatively rare, and most often, individuals seek medical attention after puberty. This condition typically goes unnoticed in childhood since the curvature becomes apparent only during erection. However, adult men may encounter unexpected difficulties when attempting sexual intercourse due to this condition.
Congenital penile curvature is relatively rare, and most often, individuals seek medical attention after puberty. This condition typically goes unnoticed in childhood since the curvature becomes apparent only during erection. However, adult men may encounter unexpected difficulties when attempting sexual intercourse due to this condition.
The degree of penile curvature and the frequency of accompanying sexual dysfunction vary. Among affected individuals, lateral (24%) and dorsal (5%) curvatures are observed, but the most common is ventral curvature, where the penis points downwards. This can lead to both physiological and psychological difficulties, particularly among young men.
Most often, surgical correction is required to address this anomaly, as without medical intervention, the quality of life for the patient remains consistently impaired.
The young man nervously fidgets in his chair, almost on the verge of tears. It's clear he's extremely uncomfortable being here, wishing he could disappear or escape, but he's obliged to sit in my office because only I can help with his issue.
-Doctor, you see, I've had a slight curvature my whole life, and I always thought it was normal... until I ended up in bed with a girl and couldn't perform at all. I don't even know if I should bother with treatment now because I don't have a girlfriend anymore, and the desire is completely gone, the patient bitterly chuckles. There are asexuals in the world, right? They manage somehow...
This is a fairly common situation. Because it's an intimate issue, boys typically don't discuss it with their parents, and doctors may not notice anomalies even during urological exams because it only manifests during erection when the erectile bodies of the penis fill with blood. As a result, the young man grows up believing everything is fine or mostly fine, since urination is normal and there's no pain, meaning the condition doesn't interfere with daily life until a certain point. At the moment of their first sexual encounter, it turns out the anomaly does exist, and from there, it's up to chance. Some take swift action to address the "malfunction" because they're calm and well-informed, while others fall into depression. Much of this depends on the delicacy of the partner: the first sexual act is already a responsible matter, and if the girl also criticizes or mocks...
Fortunately, modern andrology successfully addresses both the physical deficiency and the psychological trauma.
No, you should definitely consider treatment, I try to sound as convincing as possible. There's a microsurgical operation that can almost guarantee to help you—penile cavernosal rotation.
Rotation? The young man looks slightly surprised. You'll turn my penis so it points upwards? Not exactly turning it upside down, but by applying rotational sutures, we can correct the position of the cavernosal bodies to normal. Soon, you'll forget about this anomaly and be able to lead a completely normal life
Indications for Shaeer's operation
The main indications for performing the operation are:
- Significant curvature angle (angles clinically considered significant are over 30°, with angles over 60° likely leading to the inability to engage in sexual intercourse altogether).
- Presence of aesthetic and functional problems causing discomfort to the patient. However, the interventions most commonly indicated for surgical treatment of penile curvature in Peyronie's disease often do not yield the desired effect:
- Nesbit's plication can result in significant penile shortening because the curvature is uniformly distributed, necessitating more sutures than usual.
- Tunical grafting may not always produce visible results because the issue lies not only in the tunica itself but also in the deformed cavernous bodies.
At the same time, Shaeer's technique of rotating the cavernous bodies, which involves altering their shape through the application of specialized sutures, yields good long-term results.
The patient hesitated.
-I'm just, doctor, the thing is... well, I've become indifferent towards girls. And even if I like someone...
-You're afraid of intimacy and don't want to pursue relationships?
-Yes. I'm practically phobic of women now. Even if one of my classmates accidentally touches me at uni, I recoil. Cold sweat breaks out and I start shaking.
-Of course! After being made fun of, you lose interest in everything. Honestly, they should introduce a course on sexual etiquette in schools. How many men suffer from erectile dysfunction because someone offended them with good intentions?
-This is also fixable. It's likely that your phobia will go away on its own once we correct the anomaly. But if not, there are therapists who specialize in these kinds of problems. If difficulties persist after recovery, I'll give you the contact information for one of them...
-In this patient's case, it wasn't necessary. After the surgery, he diligently attended follow-up appointments, and the healing process went smoothly (as it does in 99% of such interventions). Two years later, just before graduating from university, he got married. How do I know this? Many of my former patients reach out to me either after their wedding or after the birth of their child, thanking me. It's just part of the job.
Rotation of the cavernous bodies is performed under general anesthesia. The Shaeer operation is conducted in several stages:
- Placement of a vascular catheter to induce artificial erection.
- Making a circular incision and dissecting the fascia of the penis.
- Division of the neurovascular bundle along its entire length.
- Creating an artificial erection to assess the nature of penile curvature.
- Application of rotational sutures.
- Restoration of the integrity of the skin covering.
After the surgery, standard restrictions for such procedures apply. It is important to regulate erectile function as much as possible, limit sexual intercourse initially, avoid visiting baths, saunas, and pools. Regular scheduled check-ups with the treating physician are necessary, and it is essential to strictly follow their recommendations.
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