Dr Herazy,

I do not know if I my curvature is PD related or congenital. What are some of the signs that point to a congenital curve versus a PD distortion? It's frustrating because my condition seems to exhibit signs of both congenital and PD. I'm sure seeing a urologist is required to say for sure but even then apparently some will misdiagnose simply because they can't find the scar tissue present in PD. So, even that avenue doesn't seem to be a sure fire way of knowing 100%.

We know that PD is caused by an excess of scar tissue buildup in the tunica albuginea due to physical trauma to that area. But what causes the distortion in the congenital curvature? Is it an excess of scar tissue one is "born with"? If not, what would cause a penis to curve in dramatic fashion (35º- 45º downward) w/o scar buildup? To me that would seem to be an exceedingly rare condition to be born with. I could see a 5º, even 10º curve but 45º is a heck of a curve to be born with. If a congenital curve has no scar tissue, how do the PDI therapies treat it in that case since there would be no scar tissue to heal?

Secondly, if one does have a congenital curve, does the treatment for it change in any way from that of a PD distortion? How successful are your PD therapies at treating congenital curvature and do you even intend on doing a full study on this?

As you can tell, not knowing for certain whether my curvature is PD or congenital, I have quite a few questions regarding the both of them. Please help me make sense of the differences and their subsequent treatment.

Thank you.

Greetings,

Thank you for the great question. 

Probably the answer to your question is found with the easiest and most fundamental observation that you can make.   The basic difference between a penis that is bent due to Peyronie's disease and one that is congenitally curved penis is time.  When did you first notice that your penis is not straight?  

If you have always noticed, even as a young boy, that your erect penis is bent then you probably have a congenital curvature of the penis. 

If you have only recently noticed that your previously straight (or almost straight) erect penis is suddenly curved or distorted in some way, then you probably have a bent penis due to Peyronie's plaque that has altered the ability of penis to expand fully.

Usually, a congenital penis curvature is not accompanied by pain, while a recent case of Peyronie's disease can be painful.   Further, a congenital penis curvature is not accompanied by a palpable nodule or mass of fibrous tissue, while a recent case of Peyronie's disease will demonstrate plaque formation.  This plaque formation is not always easily located, so it can be deceptive to make a diagnosis of PD based solely on the ability to locate this foreign tissue.

In congenital curvature there is no scar material in the shaft.  The curvature in this case is simply due to corpora cavernosa chambers that are not of equal size or dimensions.   Just like you might have ears that are not the same size or shape, or large toes, or thumbs, the body is not always symmetrical.   

I do not have a lot of information about congenital curvature responding to the PDI treatment protocol because men simply do not report this kind of information back to me.  I can tell you that over the years I have a number of men say that the gentle manual penis stretching technique coupled with a good dose of systemic enzymes like Neprinol made a difference with their congenitally bent penis.  TRH