Peyronie's Disease vs. Congenital Penile Curvature

Formation Mechanisms Are Different

Congenital penile curvature arises as a result of the tube structures (corpora cavernosa) that provide erection not growing at equal speeds. It can be noticed by the patient himself during puberty, or by parents during infancy and childhood if the degree of curvature is high.

Unlike congenital penile curvature, there is no developmental anomaly in the tube structures in acquired penile curvature. The cause of the curvature is the formation of plaque tissue in the flexible sheath (tunica albuginea) that surrounds and holds the tube structures together.

• In the acute phase where plaque tissue begins to form, Peyronie's disease causes patients to feel pain and distress.

• In the chronic phase when plaque formation is completed, the penis curves, sexual intercourse may become painful, and as I mentioned earlier, it may become physically impossible.

Risk Factors Are Different

The exact causes of both congenital penile curvature and Peyronie's disease are not yet known. However, the presence of risk factors can be mentioned for both conditions.

• In congenital penile curvature, a condition called Hypospadias, where the urinary opening (urethral meatus) is located lower than its ideal position, is accepted as a risk factor.

• It is known that connective tissue disorders, diabetes-induced erectile dysfunction, genetic factors, trauma to the penis, advancing age, and immune system diseases can increase the risk of developing Peyronie's disease.

Prevalence Rates Are Different

Experts estimate that the rate of Peyronie's disease in men between the ages of 40 and 70 is around 6% to 10%. However, it is emphasized that these estimates do not fully reflect reality and the actual rates may be higher.

The same situation applies to congenital curvature; although reports suggest the prevalence is around 1%, real rates are thought to hover around 8% - 10%.

Treatments Are Different

The fact that the formation mechanisms of these two fundamental conditions leading to penile curvature are different leads to the differentiation of treatment processes.

• In Congenital Penile Curvature: Corrective sutures (plication sutures) are placed in the direction opposite to the part where the curvature occurs in the tube structures. The operation is fundamentally performed to correct the tube structures. During the surgery, which must be performed by surgeons with microsurgical experience, the nerves and vessels (neurovascular bundle) on the tube structures must be separated with precision. Additionally, attention must be paid to ensuring the symmetry of the tube structures and preserving penile length.

• In Peyronie's Surgery: Intervention is made not on the tube structures but on the sheath where plaque formation is observed. These hard formations, which can be felt when the penis is touched, are excised from the sheath. Instead of the part removed with the plaque from the sheath, patches (grafts) that have similar characteristics to the sheath tissue and are compatible with the tissue are used. During Peyronie's surgery, grafting can be done with veins taken from different parts of the body (e.g., saphenous vein) or with synthetic materials. Different techniques can also be included in Peyronie's surgery planning in line with the patient's needs.

Whether congenital or acquired, if the degree of curvature increases, penile curvature can cause negative effects on individuals' sexual lives and self-confidence. With developing medical technologies and techniques, penile curvature treatment can be performed successfully.