Abstract
Congenital chordee and penile torsion are commonly observed in the presence of hypospadias, but can also be seen in boys with the meatus in its orthotopic position. Varying degrees of penile curvature are observed in 4–10% of males in the absence of hypospadias. Penile torsion can be observed at birth or in older boys who were circumcised at birth. Surgical management of congenital curvature without hypospadias can present a challenge to the pediatric urologist. The most widely used surgical techniques include penile degloving and dorsal plication. This paper will review the current theories for the etiology of penile curvature, discuss the spectrum of severity of congenital chordee and penile torsion, and present varying surgical techniques for the correction of penile curvature in the absence of hypospadias.
Highlights
A penis should be straight; i.e., the corpora straight, the skin sufficiently lax to avert traction, and the glans with no element of torsion
Snodgrass et al found no histological evidence of fibrous bands or dysplastic tissue in the urethral plate of boys with varying degrees of hypospadias with and without chordee; all samples demonstrated well-vascularized connective tissue comprised of smooth muscle and collagen[18], which was consistent with previous case reports[10,19]
Repair of dorsal chordee is recommended when curvature is more than 30 degrees and/or associated with hypospadias[20]
Summary
A penis should be straight; i.e., the corpora straight, the skin sufficiently lax to avert traction, and the glans with no element of torsion. Penile curvature, including chordee and penile torsion, can be found in boys with and without hypospadias. Penile curvature is a spectrum of disease most commonly associated with hypospadias, but is not uncommon in boys with an orthotopic meatus. TheScientificWorldJOURNAL (2011) 11, 1470–1478 is substantially higher, 4–10% of male births[3,4] Penile torsion is another curvature malformation that can be congenital and associated with hypospadias, or can be acquired after circumcision[5,6]. It results in a rotational defect of the penile shaft, most commonly in the counterclockwise direction.
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