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 components (Corpora Cavernosa) that make up the penis.
Because circumcision is common in Israel, the number of children suffering from penile curvature is higher compared to 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
If surgical correction is chosen, the surgery is usually performed between 6 and 12 months of age. The procedure is done as an outpatient surgical day care, meaning the child is released on the same day of surgery after full awakening and urination.
In most cases, the surgical correction of penile curvature involves releasing and realigning the penile skin around the curvature, often accompanied by correcting torsion. In some cases, fixing a part of the penis with sutures might be necessary to align or correct the torsion. In the majority of cases, the operated child won't require a catheter in the urethra after surgery and will urinate independently.
In the pediatric urology department at Shaare Zedek Medical Center, we follow an approach of using a special adhesive instead of a pressure dressing on the suture line to improve the cosmetic appearance of the penis after the surgery.
Possible Complications
Apart from general surgical complications like 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, but only periodic monitoring. In rare cases, additional surgery might be required to correct existing issues.
The pediatric urology department at Shaare Zedek Medical Center in Jerusalem has extensive experience in performing such surgeries, as evidenced by numerous publications by the department's researchers in ithe nternational professional literature on these topics.