What is penile curvature?
During erection the penis may bend downward, upward or to the side. Congenital curvature often occurs together with hypospadias, but it is sometimes seen when the urinary opening is in the normal place.
Penile torsion is rotation of the penis around its own axis: the head of the penis and the urinary opening are not straight but turned to the side. It most often rotates to the left.
Causes
- short skin or a short urethra on the underside of the penis,
- uneven development of the erectile bodies of the penis,
- uneven distribution of the skin over the penis.
When does it cause problems?
- marked curvature may cause difficulties with sexual function later in life, but the angle alone does not decide whether surgery is needed,
- marked torsion (more than about 90 degrees) can turn the urine stream to the side and cause cosmetic concern,
- mild curvature and torsion usually cause no problems.
Treatment
The approach depends on the type of curvature:
- Curvature with hypospadias is corrected as part of the hypospadias repair. This operation is usually done at 6–18 months of age.
- Isolated congenital curvature (the urinary opening is in the normal place): observation is usually enough during childhood. The need for surgery is decided by functional impact and individual concern; timing is chosen separately, often when the child can take part in the decision. A curvature of more than 30 degrees is not, by itself, an automatic reason for surgery.
- Penile torsion is assessed separately. Mild torsion usually needs no treatment; correction of marked torsion is discussed individually.
When correction is needed, it is done surgically: the skin of the penis is freed, the erectile bodies are straightened when needed, and the skin is redistributed.
If there is curvature or torsion, see a pediatric urologist before circumcision: the foreskin may be used in the corrective operation, and a separate circumcision makes the correction more difficult.
Note for pediatricians and family doctors
Ventral curvature without hypospadias (chordee without hypospadias) and penile torsion should be recognized before circumcision, because the prepuce may be needed for the repair. Torsion is usually counterclockwise, to the left; torsion of less than 60 degrees is often only cosmetic and is assessed separately. In isolated congenital curvature, observation during childhood is usually chosen: the decision on surgery is based on functional impact, individual concern and an age when the child can take part in the decision. A curvature of >30° alone is not an automatic indication for surgery. In adolescents, a photograph of the erection is useful for evaluation.
What happens at the visit?
- The direction of the penis, the position of the urinary opening and the distribution of the skin are examined.
- In babies, curvature is sometimes assessed during a spontaneous erection; in adolescents, with a photograph taken by the parent or the adolescent.
- Curvature with hypospadias is corrected during the hypospadias repair, usually at 6–18 months of age. For isolated curvature and torsion, the need for correction and its timing are decided individually.
Frequently asked questions
The penis is turned slightly to the left. Is this a problem?
Mild torsion is common and usually causes no problems. If the torsion is very marked or occurs together with hypospadias, correction is discussed.
If the curvature is more than 30 degrees, is surgery always needed?
The angle alone is not enough to decide. In isolated curvature, the decision takes into account the effect on function and individual concern. Timing is often chosen when the child is old enough to take part in the decision.
Related topics
Sources
References to the EAU Paediatric Urology guidelines were checked against the 2026 edition (October 2026).
This information is for educational purposes and does not replace medical advice. Decisions about your child’s treatment are made with the doctor after an examination.
Updated: