I am 38 and have a 30-degree ventral and 45-degree left curvature with moderate to severe pain and discomfort. I do not recall a time when I did not have this curvature and therefore believe I have a congenital curvature rather than Peyronie’s disease. It appears that men with congenital curvature rarely experience pain. Is it normal to have pain with congenital curvature, and is it possible and/or likely to have Peyronie’s disease and congenital curvature?

Dr. Levine answers: This is a good question which addresses a complex problem. Men who are born with congenital curvature or chordee typically have ventral, downward curvatures, but may have lateral or even dorsal curvatures. Depending upon the hardness of the erection and the pressures being placed on it, this could cause discomfort because of torque on the bent penis. If there is no palpable scar and the curvature has been present since you remember having erections, is it likely this is congenital curvature. On the other hand, men who have congenital curvature can possibly injure their penis which could result in scarring which can resemble Peyronie’s disease and may in fact be Peyronie’s disease. This is unusual in my experience, but I have seen men with scarring as a result of repetitive penile trauma.

The primary treatment approach for those with no active scarring process is to perform penile straightening with tunica plication. This has a high success rate. Although traction therapy has been recommended for Peyronie’s disease, there is little reported experience correction of deformity for men with congenital curvature.