What should I do if my penis has “rickets”?

Penis curvature, as the name implies, is called penis curvature when the penis is bent in any single direction such as upward, downward or lateral in the erect state, or combined with 2 directions. There are many causes of penis curvature: 1, congenital hypospadias or urethral cleft when the urethral corpus cavernosum is abnormally developed or lack of urethral corpus cavernosum, while abnormal fibrous cords lead to downward or upward curvature of the penis when erect; 2, foreskin ties are too short or unevenly developed penile skin, pulling the penis to cause curvature; 3, penile corpus cavernosum sclerosis, which not only causes penis curvature, but also causes erection pain and sexual function 4, the penis white membrane development abnormalities and uneven development, both sides of the elasticity is different, resulting in the penis up, down or lateral bending; 5, penis trauma, masturbation or excessive force during sex, improper sexual position, resulting in penile injury and white membrane rupture, later the formation of scarring, resulting in penile curvature.  Although the penis curvature deformity in male external genital deformity is relatively rare, but easy to cause erection or pain during sex, when the bending angle is greater than 20 degrees, resulting in difficulties in sexual intercourse, or even can not be inserted, even if inserted will continue to stimulate a local part of the vagina and very easy to cause female dissatisfaction, resulting in patients and spouses to reduce the quality of life. There is no effective medication for penile curvature, so surgery is required when the penis has been curved for more than 6-9 months and any of the following conditions are present: significant pain, curvature angle greater than 30 degrees, difficulty in intercourse, and female dissatisfaction. At present, the most effective international surgical treatment for penile curvature has two methods: the first: when the penis is long enough to use the “16-point method” to fold and suture the white membrane of the penis from the curved projection to correct the curvature; the second: when the length of the penis is small to use the patch to repair the curved part, without affecting the length of the penis to correct the curvature. Both surgical methods have their strict indications and advantages and disadvantages, and the specific surgical method needs to be chosen according to the patient’s specific situation. The shortening of the penis after surgery is the disadvantage of the “16-point” method of penile white membrane folding. The length of post-operative shortening varies depending on the angle of penile curvature, and the length of post-operative shortening is generally about 0.5-50px, with an average of about 25px. Therefore, we only perform the “16-point method” of penile white membrane folding for patients with sufficient penile length. Generally speaking, the length of the penis can be fully normalized when it exceeds 8-225 px, so patients whose penis length exceeds 10-275 px before the surgery can be completely subjected to the “16-point” penile white membrane folding procedure. As the curvature of the penis affects the sexual life or even cannot have sex, the patient loses about 25px of penis length after the operation and gains a normal sexual life, so most of the patients who undergo this operation do not have much dissatisfaction with the shortening of the penis after the operation.  The residual penile curvature or recurrence after “16-point” penile white membrane folding surgery is related to the surgeon’s surgical skills or the poor development and partial tearing of the white membrane of the patient’s penile corpus cavernosum. The “16-point” penile folding procedure is performed by folding sutures on the white membrane of the penis and adjusting the tension of the sutures to correct the curvature. Normally developed penile tunica albuginea is a very tough tissue, but we found during the operation that the tunica albuginea is poorly developed and thin in patients with penile curvature. Therefore, after penile curvature surgery, the white membrane may tear in some patients and the curvature may recur. It is like when we use a very strong thread to mend the fabric, if the fabric is very strong, the fabric will not tear even if we pull the fabric, but if the fabric is old and not strong, it can be torn even if we pull the fabric gently. Since we strictly control the position of the sutures and the tension of the sutures, we have not had a single case of recurrence after the surgery. There are many patients who have been referred to our hospital for recurrence after surgery without mastering this surgical technique. In addition, in order to avoid residual bending after surgery, we generally achieve mild overcorrection during surgery, which largely avoids residual bending after surgery. Sometimes patients with very poorly developed cavernous white membranes may have a residual curvature of about 10 degrees, but rarely more than 20 degrees. It is difficult to completely avoid residuals in such patients with poor cavernous development, so we do not recommend reoperation when the curvature recurs at less than 30 degrees.