• Congenital penile curvature. In: Tekgul S, Riedmiller H, Gerharz E, Hoebeke P, Kocvara R, Nijman R, Radmayr C, Stein R. Guidelines on paediatric urology. Arnhem, The Netherlands: European Association of Urology, European Society for Paediatric Urology; 2009 Mar. p. 22-3. [8 references]

This is the current release of the guideline.

This guideline was originally published in March 2008. It was republished with no changes in March 2009.

Levels of evidence (1a-4) are defined at the end of the "Major Recommendations" field.

Background

Penile curvature may be ventral, dorsal or lateral. Most of ventral curvatures are associated with hypospadias due to chordee or ventral dysplasia of cavernous bodies. Similarly, the dorsal curvature is mostly associated with epispadias. Isolated penile curvature is not frequent with an incidence of 0.6% (Level of evidence: 2). The curvature is caused by asymmetry of the cavernous bodies.

Curvature over 30 degrees is considered clinically significant; curvature over 60 degrees may interfere with satisfactory sexual intercourse in adulthood (Level of evidence: 4).

Diagnosis

Diagnosis is made during hypospadias or epispadias repair using an artificial erection. The isolated anomaly is usually not recognized until later in childhood because the appearance of the penis is normal. The curvature is only observed during erections.

Treatment

The treatment is surgical. An artificial erection is used to determine the degree of curvature and to check the symmetry after the repair.

In hypospadias, chordee related to the tethering of the ventral skin and to the spongiosal pillars is first released. Only in a few cases the penile curvature is caused by a short urethral plate, which should be cut.

To repair the corporeal angulation in the isolated curvature or curvature associated with hypospadias, different techniques of plication of corpora cavernosa (orthoplasty) are used.

In epispadias, a combination of complete release of the urethral body from the corpora and a different kind of corporoplasty with or without corporotomy is usually necessary to achieve a straight penis.

Definitions:

Levels of Evidence

1a Evidence obtained from meta-analysis of randomized trials

1b Evidence obtained from at least one randomized trial

2a Evidence obtained from at least one well-designed controlled study without randomization

2b Evidence obtained from at least one other type of well-designed quasi-experimental study

3 Evidence obtained from well-designed non-experimental studies, such as comparative studies, correlation studies and case reports

4 Evidence obtained from expert committee reports or opinions or clinical experience of respected authorities

None provided

The type of supporting evidence is not specifically stated for each recommendation.

• Congenital penile curvature. In: Tekgul S, Riedmiller H, Gerharz E, Hoebeke P, Kocvara R, Nijman R, Radmayr C, Stein R. Guidelines on paediatric urology. Arnhem, The Netherlands: European Association of Urology, European Society for Paediatric Urology; 2009 Mar. p. 22-3. [8 references]

Not applicable: The guideline was not adapted from another source.

2008 Mar (republished 2009 Mar)

European Association of Urology - Medical Specialty Society
European Society for Paediatric Urology - Medical Specialty Society

European Association of Urology

Not stated

Primary Authors: S. Tekgül; H. Riedmiller; E. Gerharz; P. Hoebeke; R. Kocvara; R. Nijman; Chr. Radmayr; R. Stein

All members of the working group submit a conflict of interest form. The information is kept on file in the European Association of Urology (EAU) Central Office database. This guidelines document was developed with the financial support of the EAU. No external sources of funding and support have been involved. The EAU is a non-profit organisation and funding is limited to administrative assistance, travel, and meeting expenses. No honoraria or other reimbursements have been provided.

This is the current release of the guideline.

This guideline was originally published in March 2008. It was republished with no changes in March 2009.

None available

This NGC summary was completed by ECRI Institute on November 14, 2008. The information was verified by the guideline developer on December 19, 2008.

This summary is based on the original guideline, which is subject to the guideline developer's copyright restrictions.

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