Penile curvature causes an inability to engage in sexual intercourse during adulthood and leads to severe functional and psychological impairments. Penile curvature in children usually develops as a result of improper healing after circumcision, incorrect circumcision technique, or occasionally as a congenital defect due to abnormal development of the corpora cavernosa (sponge-like tissue) that make up the penis.
Because circumcision is common in Israel, the rate of children with penile curvature is higher than in other parts of the world. There are clear indications for surgical correction of penile curvature. It is generally accepted that curvature of more than 300 from the midline requires surgical correction.
Another common condition is penile torsion, where the penis twists. This condition leads to a deviation of urine flow and social discomfort for the child. Similar to most cases of penile curvature, penile torsion can also result from circumcision, but sometimes it occurs as a congenital condition.
As in the case of penile curvature, there are clear indications for surgical correction here. A torsion of more than 900 requires surgical correction.
Treatment
Surgical correction is usually performed between 6 and 12 months of age. The procedure is carried out under outpatient surgical day care, meaning that the child is released on the same day of surgery after full awakening and urinating.
In most cases, the surgical correction of penile curvature involves releasing and realigning the penile skin, with a correction of the curvature or torsion. Occasionally, fixing a part of the penis with sutures might be necessary to align or correct the torsion. In the majority of cases there is no need for a catheter after surgery and the child will urinate independently.
In the pediatric urology department at Shaare Zedek Medical Center, a special adhesive is used instead of a pressure dressing on the suture line to improve the cosmetic appearance of the penis after the surgery.
Possible Complications
Apart from the possible complications related to any surgical procedure, such as leakage and infection at the suture site after surgery, there might be instances where a minor degree of curvature or torsion is left untreated after surgery. As long as it deviates minimally from the normal state, additional correction might not be necessary; periodic monitoring may suffice. In rare cases, additional surgery might be required to correct existing issues.
The pediatric urology department at Shaare Zedek Medical Center has extensive experience in performing such surgeries, as evidenced by numerous publications on these topics by the department's researchers in the international professional literature.
