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Correct of congenital penile deviations

Congenital curvatures of the penis occur from birth and do not change over the course of life. When erect, the penis is often curved downwards by up to 90 degrees. This leads to discomfort during sexual intercourse. Young adults often consult a urologist for this reason. The treatment of choice is surgical correction of the curvature of the penis. Since the cause of congenital penile curvature is not connective tissue disease, usually no further penile deviation is expected after a successful surgery. For optimal correction of penile curvature, it is necessary to release the vascular/nerve bundle. This requires a surgeon with a high level of experience.

Brief info on the correction of congenital penile deviation

Indication	Penis deviation with functional complaints during sexual intercourse
Procedure	Correction of the penile deviation using Nesbit’s method. In individual cases, stretching of the penile shaft and use of collagen fleece is also possible.
Surgery time	Approx. 1-2 hours
Clinic stay	3-4 days
Note	General anaesthesia recommended

Questions about the correction of congenital penile deviations

The skin of the shaft of the penis is detached through an incision, as in circumcision surgery. The vascular/nerve bundle is then carefully detached. According to the curvature of the pens, an approx. 1.5 cm wide part of the erectile tissue sheath is usually removed at three different points, in a procedure also known as a Nesbit operation. The erectile tissue sheath is closed by recessed, non-palpable, adsorbable sutures. The vascular-nerve bundle is retracted. The procedure ends with the adaption of the penile shaft skin.

Admission for surgery takes place on the day of the procedure. After the operation, inpatient treatment is recommended for 3 days. Sexual intercourse is possible again about one month after discharge from the clinic. It is recommended not to work for 1-2 weeks after discharge and to avoid physical exertion.

During the procedure, artificial erection is used to check the success of the corrective surgery. The procedure is only finished when the straightening is complete. Since congenital penile deviation is not the result of disease in the connective tissue, the risk of renewed penile curvature is low.

To stretch the shaft of the penis, it is necessary to release the vascular/nerve bundle in the midline of the shaft of the penis. These nerves are sensitive and difficult to see during the surgery. The detachment of the vascular/nerve bundle must therefore be done very carefully using a suitable technique. If the vascular/nerve bundle is detached improperly, it can lead to permanent disruption in the sensation of the glans. Therefore, experience in releasing the vascular/nerve bundle is essential for a successful procedure. Prof. Dr. med. Sven Lahme has performed this procedure about 1500 times over a period of more than 25 years.