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Do You Know: Why Some Men Have “Bent” Penises?

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Blog, Do You Know?
February 23, 2022

By James Snyder, MD

As a preface, I should mention that Routine Infant Circumcision (RIC) is the reason/cause of some penile curvature in adult men (which is distinct from Peyronie’s Disease or Chordee — see below). The operators in this procedure may be medical students, nurses/midwives, obstetricians, pediatricians, or anyone who is being taught to do a “simple” infant circumcision. The fact is this procedure is often underestimated in terms of risk, and it is delegated to the least experienced operator. Removal of skin from the penis to reveal the Glans Penis is the primary goal, but the results/complications/mistakes of the operator may become evident only after years have passed and the subject is unable to obtain redress of grievances. The most careful RIC removes up to 1/3 to 2/3 of the skin of the normal penis. This skin does not regenerate as the child becomes an adult; the results can be tragic when the removal of skin leaves behind shortening, unequal and asymmetric coverage, curvature, and sexual crippling. Now I will proceed to a discussion of two well-known natural causes of penile deformities – Peyronie’s Disease and Chordee.

Peyronie’s Disease or the “Bent Spike Syndrome” begins as a thickening of the fibrous sheaths which surround the two erectile bodies of the penis. These erectile bodies are attached to the bony pelvis and continue through the length of the penis to attach to the Glans Penis. During sexual arousal, these bodies fill with blood to the limits of the fibrous sheaths which define the size and shape of the penis. At the same time, the urethra, a tube which conducts urine and semen from the bladder and prostate, also engorges with blood. These structures and their various functions are most easily understood by consulting books of Anatomy, such as Grey’s Anatomy or Grant’s Atlas of Anatomy, found in most libraries.

Peyronie’s affects the erectile bodies of middle-aged men, causing painful erections with curvature and distortions of the shape of the penis, which may prevent normal sexual intercourse. The condition is sometimes associated with Dupuytren’s contracture of the tendons on the palm of the hand. The cause of these conditions is poorly understood, and various treatments have resulted in incomplete cure of the disease which usually worsens over time.

Urologic specialists at the Mayo Clinic see about 700 patients yearly with this condition and have developed appropriate medical and surgical treatments which may include injections, traction, and surgery.

Chordee (pronounced Cor-DEE) is a curvature of the penis toward the feet (ventral or ventrally). This is a normal condition after conception when the embryo develops all the essential organs to support life and becomes a fetus. Early in this process, the sexual organs begin to develop and differentiate between males and females. At first, the phallus is curved ventrally in both sexes. The secretion of the male sex hormone, testosterone, by the fetal gonads causes the male phallus to enlarge, unwind, and take a more nearly straight form. Later, the skin which will become the scrotum folds to the midline and encloses the testicles, continuing this process and forming the tube which conducts urine, the urethra, similar to the action of a zipper until the distal end of the penis is reached.

The condition known as Hypospadias is a failure of this process to complete any or all of these described formations. In the most severe forms, the Chordee fails to resolve, and the distal penis remains close to its original form. More commonly, the penis is completely formed except for the ventral curvature, which may be more or less severe. In the milder forms, the curvature can be surgically corrected when the Urologic Surgeon makes a skin incision along the length of the penis on the dorsal or upper surface and removes or cuts out a series of wedges from the fibrous sheath of the erectile bodies. This may improve the shape or curvature of the penis to allow normal sexual function.

This is an abbreviated discussion of these conditions, which, fortunately for humanity, are not common. In my experience as a Urologic Surgeon, I have encountered these conditions only a few times. The best treatment options are available from experienced surgeons working at university medical centers.

James L Snyder, MD
Fellow, American College of Surgeons
Diplomate, American Board of Urology

Persons interested in learning more about Peyronie’s Disease and its treatment, including surgery and the use of injectable medication, may consult the Mayo Clinic website.

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Marilyn

Marilyn Fayre Milos, multiple award winner for her humanitarian work to end routine infant circumcision in the United States and advocating for the rights of infants and children to genital autonomy, has written a warm and compelling memoir of her path to becoming “the founding mother of the intactivist movement.” Needing to support her family as a single mother in the early sixties, Milos taught banjo—having learned to play from Jerry Garcia (later of The Grateful Dead)—and worked as an assistant to comedian and social critic Lenny Bruce, typing out the content of his shows and transcribing court proceedings of his trials for obscenity. After Lenny’s death, she found her voice as an activist as part of the counterculture revolution, living in Haight Ashbury in San Francisco during the 1967 Summer of Love, and honed her organizational skills by creating an alternative education open classroom (still operating) in Marin County. 

After witnessing the pain and trauma of the circumcision of a newborn baby boy when she was a nursing student at Marin College, Milos learned everything she could about why infants were subjected to such brutal surgery. The more she read and discovered, the more convinced she became that circumcision had no medical benefits. As a nurse on the obstetrical unit at Marin General Hospital, she committed to making sure parents understood what circumcision entailed before signing a consent form. Considered an agitator and forced to resign in 1985, she co-founded NOCIRC (National Organization of Circumcision Information Resource Centers) and began organizing international symposia on circumcision, genital autonomy, and human rights. Milos edited and published the proceedings from the above-mentioned symposia and has written numerous articles in her quest to end circumcision and protect children’s bodily integrity. She currently serves on the board of directors of Intact America.

Georganne

Georganne Chapin is a healthcare expert, attorney, social justice advocate, and founding executive director of Intact America, the nation’s most influential organization opposing the U.S. medical industry’s penchant for surgically altering the genitals of male children (“circumcision”). Under her leadership, Intact America has definitively documented tactics used by U.S. doctors and healthcare facilities to pathologize the male foreskin, pressure parents into circumcising their sons, and forcibly retract the foreskins of intact boys, creating potentially lifelong, iatrogenic harm. 

Chapin holds a BA in Anthropology from Barnard College, and a Master’s degree in Sociomedical Sciences from Columbia University. For 25 years, she served as president and chief executive officer of Hudson Health Plan, a nonprofit Medicaid insurer in New York’s Hudson Valley. Mid-career, she enrolled in an evening law program, where she explored the legal and ethical issues underlying routine male circumcision, a subject that had interested her since witnessing the aftermath of the surgery conducted on her younger brother. She received her Juris Doctor degree from Pace University School of Law in 2003, and was subsequently admitted to the New York Bar. As an adjunct professor, she taught Bioethics and Medicaid and Disability Law at Pace, and Bioethics in Dominican College’s doctoral program for advanced practice nurses.

In 2004, Chapin founded the nonprofit Hudson Center for Health Equity and Quality, a company that designs software and provides consulting services designed to reduce administrative complexities, streamline and integrate data collection and reporting, and enhance access to care for those in need. In 2008, she co-founded Intact America.

Chapin has published many articles and op-ed essays, and has been interviewed on local, national and international television, radio and podcasts about ways the U.S. healthcare system prioritizes profits over people’s basic needs. She cites routine (nontherapeutic) infant circumcision as a prime example of a practice that wastes money and harms boys and the men they will become. This Penis Business: A Memoir is her first book.