What is a penile curvature?

Acquired penile curvature , also called Induratio Penis Plastica (IPP), is a scarring of the penis that is the reason of the curvature. The disease has two phases: an acute inflammatory phase and a chronic phase. The acute stage of the IPP can be quite painful and is characterized by an increasing and decreasing curvature of the penis. The penile curvature can be so severe, that normal sexual intercourse is no longer possible

Which non-surgical therapies are available?

The acute phase of the IPP requires a symptom-based therapy. Here, anti-inflammatory drugs can be effective in combating the pain. If erection is impaired, drugs to promote stiffness may be used. In the last few years, various substances such as vitamin E or Potaba were used as therapeutic agents; unfortunately, the data as to their effectiveness did not stand up to a critical analysis based on European guidelines.

Extracorporeal shock-wave therapy (ESWT) represents an alternative to drug therapy in the acute phase of IPP. Shock waves are delivered to the affected area of the penis. It is assumed that the ESWT destroys calcified structures and improves blood circulation with a subsequent reabsorption of the calcification. This therapy in particular relieves pain. However, in spite of extensive studies, no permanent improvement of the curvature has been shown beyond doubt to date. A treatment takes about 15-20 minutes. Depending on the severity, about 6 to 10 therapy sessions will be required. The therapy is painless and carried out on an outpatient basis at our clinic.

For the chronic phase, an injection therapy is available as an alternative. It consists of active agents that are directly injected into the plaques to loosen it. This may reduce the curvature of the penis. However, the collagenase preparation often used for this purpose in the past was withdrawn from the market in 2020.

A penis extender to stretch the penis has to be used for several hours a day, however. This can reduce the curvature, too. This is a quite difficult procedure though, as the penis extender has to be used many hours per day and over a period of months. Besides, there is no clear scientific proof of its effectiveness yet.

What circumstances require surgery?

If a patient’s quality of life is significantly reduced due to the curvature of the penis and intercourse no longer possible, surgery can be performed in the chronic phase. Various techniques to straighten the penis are available. However, depending on the technique decided on, these procedures may shorten the penis somewhat. Thus, the choice of the optimum procedure to adopt always is an individual decision.