Curved Penis Information

Why is my penis bent?

A curved penis can be still be normal and healthy if that is the way it was developed during formation in the womb.   Many men have a penis that displays a slight to moderate, present all their lives, completely capable of a full and pain-free erection – just not straight like an arrow.  Their bent penis is just a unique physical variation, of no great consequence like one toe that is shorter than the other or unusually long eyelashes; these are just some of the things that make us unique people.

In a healthy penis the internal tissue is flexible and expandable to allow for a normal erection to develop when blood is trapped inside.  Since there are a total of three chambers within the penis that fill with blood to create an erection, these chambers must be of the same length and girth in order for an erection to be perfectly straight.   When a boy is born with one of these three chambers that is slightly smaller or larger than the other two, he will have an erection that is curved.

For Peyronie’s disease to develop an area of the healthy and elastic tissue layer below the skin surface (tunica albuginea) that covers these chambers becomes injured.  As the injury begins to heal something not completely understood goes wrong, and it is replaced an excessive amount of  dense and inelastic fibrous tissue, called a Peyronie’s plaque or scar.  This fibrous mass of plaque tissue is below the surface of the skin and therefore cannot be seen.

Normally when an erection occurs the spongy and elastic tissue within the three penis chambers fill with blood to cause the penis to stretch and  expand, equally increasing the length and circumference (girth) of the penis.  However, when the fibrous Peyronie’s plaque is located within the deep layer of the tunica albuginea it is in a perfect location to interfere with and alter the expansion and stretching of the penis during an erection.  As a result the fibrous scar prevents the elastic tissue layer from expanding fully in the area it is located resulting in a bend, curve, dent, hourglass or bottleneck deformity of the penile shaft.

At the start of Peyronie’s disease the penis curve is absent or very slight.  This happens because the area of injury and scar formation is an undeveloped nodule or bump on the top or sides of the penile shaft immediately below the surface of the skin that is too small to cause a penile curvature.   During the next few weeks or several months this small area of density will slowly change into an irregularly shaped flattened mass of variable size, shape, density and surface quality.  Scars that develop as a result of injury along the length of the top of shaft can be as long as the penis, and very narrow or as wide as a half inch or more.  Other large scars can circle the shaft like a collar, and create what is called a bottle neck deformity. When a Peyronie’s plaque or scar is either so soft or small, or is so flat with thin and vague edges it can be very difficult to locate.

Even when a scar or plaque cannot be found it is assumed to exist when there is recent structural change in the penis like the development of a curve, bend or similar unusual alteration that had not been present previously.   The distortion that is visible from the exterior is strong clinical evidence of the presence of the scar on the interior causing it.

How a curved penis affects sexual intercourse

Peyronie’s disease is sometimes called the “bent nail disease” because the penis can be so severely curved penis as to prevent sexual penetration.   Distortions of the penis are sometimes so so severe they are described as “cork screw” or “cane handle.”

It is estimated that 50-75% of couples who deal with Peyronie’s disease will experience one or more different levels of problem with sexual intercourse. The most common problem encountered with sexual intercourse is difficult or painful sexual penetration as a result of greatly curved or bent penis that makes penetration physically impossible or so painful for one or both partners that intercourse impossible.

Further compromising and limiting sexual activity is the incomplete filling with blood that can also develop in Peyronies that results in a small or large area of softness of the penile shaft. This softness causes a weakness of the normally turgid erection that can cause additional difficulty for the sexual act.

Almost all Peyronies couples have an occasional or minor sexual difficulty related to penile distortion or reduced  firmness of the penis.  Because sexual activity is complicated by many physical, social and emotional issues when there are no health problems present, the couple who must struggle with Peyronie’s disease are likely to suddenly encounter a flood of surprises and problems they are unprepared to deal with successfully.  If your Peyronie’s penis is causing sexual distress, you might be interested in the in-depth and detailed discussion and loads of helpful information found in Dr. Herazy’s  second book, “Peyronie’s Disease and Sex.”

How does the penis become curved in Peyronie’s disease?

Imagine a long balloon that has not yet been blown up, and it has a small piece of tape on it.   As the balloon is inflated the tape will not expand like the rest of the balloon, and so as the rest of the balloon is getting larger the area that has the tape will not expand, causing the balloon to be distorted. 

Peyronie’s disease causes a bent or distorted penis in a similar mechanism.  As a normal penis might expand and elongate evenly it will result in a straight erection.  But in Peyronie’s disease a rather dense and inelastic  plaque tissue develops within he deeper layers of the penis.  This plaque tissue does not expand as well as the surrounding normal tissue and it will not allow the area of the penis where it is located to expand either.  When a man with Peyronie’s has an erection the plaque does not expand, thus a curve or twist results at the site where the plaque is located. 

The amount of penis distortion that occurs in a case of Peyronie’s disease can range from mild to severe.  Some PD cases are so mild as to be detected only on autopsy, while others are so severe that intercourse is impossible and surgery is necessary to reduce painful distortion. The scar may range from a few millimeters or may encompass the entire shaft of the penis. Pain, hardened scar formation and/or distortion may develop slowly or appear overnight in PD. Angulation of the erect penis from 5°- 45° is common, and can be greater; deformities can advance beyond 90º and at the extreme an erect penis may be so distorted (“J” or “corkscrew”) that intercourse is impossible or at least extremely painful for both partners.

Distortion or angulation of the non-erect penis is rare.  In a small percent of cases where the body works efficiently to reduce the tissue reaction, inflammation may be resolved early without causing significant pain or permanent bending.  Sexual difficulty and impotency also range from mild to severe, depending on the degree of deformity.  In some cases the plaque can result in the formation of a bottle-neck, collar-like, or hourglass-like deformity of the erect penis.  Additionally, the mass of fibrous scar tissue may prevent the closure of valves in the penile veins so that the hydraulic pressure needed to create an erection is never achieved.   When the Peyronie’s plaque does not allow the valves of the veins within the penis to close, blood cannot be trapped in the penis as it should to create an erection.  This inability to close the penis veins results in erectile dysfunction in which the penis is limp or soft beyond the location of the fibrous nodule, often leading to inability to have sexual intercourse.   Depending on the location of plaque in relation to the veins of the penis, this loss of hydraulic pressure can causes the penis to be soft in a very small or very large area.