Hello, I’m Prof. Dr. Volkan İzol. One of the most common issues I encounter in my urology practice is penile curvature. Penile curvature is a condition that poses both aesthetic and functional challenges for patients. It can affect their sex life, mental health, and relationships with their partners. In this article, I will comprehensively answer the most frequently asked questions, such as what penile curvature is, how it is diagnosed, whether non-surgical treatment is possible, how the surgery is performed, and when patients can resume sexual activity after surgery.

Penile curvature is an abnormal bending of the penis to the right, left, up, or down during an erection. This condition can be present from birth (congenital) or develop later in life. The most common cause of acquired penile curvature is Peyronie’s disease. Peyronie’s disease results from the formation of hard plaques in the tunica, a membrane-like layer inside the penis. These plaques prevent one side of the penis from stretching during an erection, causing a noticeable curvature.

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•Curvature in one direction during an erection

•Difficulty having sexual intercourse due to curvature

•A sensation of shortening of the penis

•Palpation of hard plaques

•Pain in some patients

In my experience, patients experience significant difficulty during sexual intercourse, especially if the curvature exceeds 30–40 degrees. Therefore, the decision to treat is based on the degree of curvature and the patient’s symptoms.

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Penile curvature can sometimes be confused with psychogenic erectile dysfunction or with temporary curvature caused by trauma. For this reason, a physical examination is very important. In Peyronie’s disease, a plaque is usually palpable, but in congenital curvature, there is no plaque.

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•Congenital (Present at Birth): This condition results from uneven development of the tunica tissue during penile development.

•Post-Traumatic: It may develop following trauma to an erect penis (a fracture during sexual intercourse).

•Peyronie's Disease: Resulting from hardening of the connective tissue and the formation of plaques.

•Connective Tissue Disorders: Systemic diseases such as diabetes and hypertension can increase the risk.

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If penile curvature does not stabilize during the first 6–12 months—that is, if the curvature is progressing—medical treatment may be the preferred option.

•Medications: Vitamin E, Potaba, pentoxifylline, and similar medications

•Injection therapies: Verapamil, interferon, or collagenase (CCH/Xiaflex), which can be injected into the plaque

•ESWT (shock wave therapy): It can reduce pain and help soften the plaques.

However, most of these methods cannot completely correct the curvature; they can only halt its progression or reduce pain.

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Surgical treatment is recommended when the curvature exceeds 30–40 degrees, when it prevents sexual intercourse, or when it significantly impairs the patient’s quality of life.

•Peyronie’s Plication (Nesbit or modifications): The tunica on the opposite side of the penis is shortened, thereby straightening the penis. It is a simple and effective method.

•Grafting Surgeries: If the curvature is very severe (60–70 degrees or more), the side with the plaque is incised and opened, and a graft is inserted in its place. Penile length is preserved.

•Penile Prosthesis Implantation: In patients who also have erectile dysfunction, this procedure both restores erections and corrects penile curvature.

We make the decision regarding surgery based on the patient’s degree of curvature, expectations, and sexual function, and select the most appropriate technique.

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•Discharge: Most of my patients return home within 24 hours after surgery.

•Pain Management: Mild pain may occur; over-the-counter pain relievers are sufficient.

•Recovery: Swelling and bruising will subside within a few weeks.

•Return to Sexual Activity: Sexual intercourse is generally permitted after 6–8 weeks.

•Mild penile shortening (especially after the plication procedure)

•Decreased erection quality (rare)

•Change in sensation or temporary numbness

•Recurrence of curvature (very rare)

When performed by an experienced surgeon, the complication rate is very low.

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Yes, surgery for penile curvature is currently the method that provides a definitive solution. Medical treatments usually cannot fully correct the curvature, but surgery can straighten the penis and restore sexual function.

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Penile curvature is a condition with both physical and psychological effects. Treatment options should be tailored to each patient. As Prof. Dr. Volkan İzol, I evaluate patients with penile curvature using modern diagnostic methods and offer non-surgical treatments or surgical solutions in appropriate cases.