A slightly bent penis is not unusual, only few men have a . However, there is also the pronounced penile curvature, which becomes a burden for those affected. According to a study conducted by Norma Katharina Ruppen‐Greeff MSc, Daniel M. Weber MD, Rita Gobet MD, Markus A. Landolt PhD that was published in the journal of sexual medicine, there are quite a few indicators that the overall look of a penis, its attractiveness, is perceived as more important by women than the size or girth.

What are the reasons for a bent or curved penis?

First of all, the erectile tissue of the penis is rarely 100% symmetric, so a slight curvature is considered absolutely normal and doesn’t require any treatment. A real congenital penile curvature is estimated to affect about 3% percent of all men. The cause is usually a defect during embryonic development, the length of the urethra is insufficiently formed or there is scarring in the connective tissue layers of the penis. The penis can’t develop regularly, which then leads to an asymmetry of the penile erectile tissue.

Acquired penile curvature, medically called Induratio Penis Plastica (IPP) or Peyronie’s disease, is much more common: it affects up to 12% percent of all men, especially men over the age of 40. In the course of the disease curvatures of the penis takes place, indentations on the penis shaft, a loss of penis length and in advanced stages also to erectile dysfunction. The exact causes for IPP have never been found. It is assumed, however, that recurring stress on the penile shaft with corresponding small micro injuries leads to the formation of fibrous plaques. These plaques are often perceived as a node changing the elasticity of the erectile tissue, causing a painful inflammation and deformation of the erectile tissue in the acute phase. Up to 80% of patients report that IPP significantly reduces penis length.

The second phase of the disease is the chronic phase, no further inflammation occurs, the penile curvature no longer changes but permanently stays without treatment. In some cases, severe penile curvature is not associated with any limitations for the affected individual, in other cases even a low degree of curvature can lead to severe sexual problems and reduced self-esteem. Medical guidelines recommend the surgical correction of a penile curvature from a degree of curvature of about 30 degrees or more.

What are the treatment options for a deformed penis?

A severe innate penile curvature can only be straightened out for a surgical intervention, but for the treatment of an acquired curvature, there are different treatment options depending on the stage of the disease. In the past, an IPP could only be straightened by surgery, called Nesbit surgery after the inventor and famous urologist Reed M. Nesbit. Today, a crooked penis does not always require immediate surgical intervention, there are promising conservative therapies that don’t negatively affect penis size like the surgery.

Injection therapy with the collagenase clostridium histolyticum (Xiaflex) can reduce the plagues and is approved by the FDA. In the chronic phase, certain medical stretching and straightening devices have shown positive long term results without the loss of size, often even combined with a small gain in overall penis size.

Important: IPP treatment should start early, make sure to see a doctor is you recognize symptoms of inflammation, pain or a beginning curvature. The earlier treatment commences, the higher the chances to avoid a severe and permanent deformation of the penis.