Chordee
Encyclopedia
Chordee is a condition in which the head of the penis
curves downward or upward, at the junction of the head and shaft of the penis. The curvature is usually most obvious during erection
, but resistance to straightening is often apparent in the flaccid state as well. In many cases but not all, chordee is associated with hypospadias
. This is not the same condition as Peyronie's disease
, which involves curvature of the shaft of the penis most commonly due to injury during adult life.
Chordee is also a complication of circumcision, though some medical professionals do not consider it to be true chordee because the corporal
bodies are normally formed. However not all congenital chordee includes abnormal corpora, and case reports of damage to the corpus cavernosum from circumcision are noted in the literature; particularly as a complication of local anesthetic.
The curvature of a chordee can involve
Severe degrees of chordee are usually associated with hypospadias
, but mild degrees of curvature may occur in many otherwise normal males. When the curved penis is small and accompanied by hypospadias, deficiency of prenatal androgen effect can be inferred.
The preferred time for surgery is between the ages of 6 and 18 months, by which time the risk from anesthesia
is low.
Correction is usually successful.
Penis
The penis is a biological feature of male animals including both vertebrates and invertebrates...
curves downward or upward, at the junction of the head and shaft of the penis. The curvature is usually most obvious during erection
Erection
Penile erection is a physiological phenomenon where the penis becomes enlarged and firm. Penile erection is the result of a complex interaction of psychological, neural, vascular and endocrine factors, and is usually, though not exclusively, associated with sexual arousal...
, but resistance to straightening is often apparent in the flaccid state as well. In many cases but not all, chordee is associated with hypospadias
Hypospadias
Hypospadias is a birth defect of the urethra in the male that involves an abnormally placed urinary meatus...
. This is not the same condition as Peyronie's disease
Peyronie's disease
Peyronie's Disease Peyronie's Disease Peyronie's Disease (also known as "Induratio penis plastica", or more recently Chronic Inflammation of the Tunica Albuginea (CITA), is a connective tissue disorder involving the growth of fibrous plaques in the soft tissue of the penis affecting up to 10% of men...
, which involves curvature of the shaft of the penis most commonly due to injury during adult life.
Presentation
It is usually considered a congenital malformation of unknown cause. Since at an early stage of fetal development the penis is curved downward, it has been proposed that chordee results from an arrest of penile development at that stage.Chordee is also a complication of circumcision, though some medical professionals do not consider it to be true chordee because the corporal
Corpus cavernosum penis
The corpus cavernosum penis is one of a pair of sponge-like regions of erectile tissue which contain most of the blood in the penis during penile erection...
bodies are normally formed. However not all congenital chordee includes abnormal corpora, and case reports of damage to the corpus cavernosum from circumcision are noted in the literature; particularly as a complication of local anesthetic.
The curvature of a chordee can involve
- tethering of the skin with urethraUrethraIn anatomy, the urethra is a tube that connects the urinary bladder to the genitals for the removal of fluids out of the body. In males, the urethra travels through the penis, and carries semen as well as urine...
and corpora of normal size; - curvature induced by fibrosisFibrosisFibrosis is the formation of excess fibrous connective tissue in an organ or tissue in a reparative or reactive process. This is as opposed to formation of fibrous tissue as a normal constituent of an organ or tissue...
and contracture of the fasciaFasciaA fascia is a layer of fibrous tissue that permeates the human body. A fascia is a connective tissue that surrounds muscles, groups of muscles, blood vessels, and nerves, binding those structures together in much the same manner as plastic wrap can be used to hold the contents of sandwiches...
l tissue (Buck's fasciaBuck's fasciaBuck's fascia is a layer of deep fascia covering the penis.It is also known as the "deep fascia of the penis".It is also sometimes simply called the "fascia of the penis", and the Terminologia Anatomica is simply "fascia penis"....
or dartosDartosThe dartos fascia is a fat-free layer of smooth muscular fiber outside the external spermatic fascia but below the skin. It is a continuation of Scarpa's fascia, which is a membranous layer of the subcutaneous tissue in the abdominal wall...
) surrounding the urethra; - disproportionately large corpora in relation to the urethral length without other demonstrable abnormality of either; or
- a short, fibrotic urethra that tethers the penis downward (the least common type).
Severe degrees of chordee are usually associated with hypospadias
Hypospadias
Hypospadias is a birth defect of the urethra in the male that involves an abnormally placed urinary meatus...
, but mild degrees of curvature may occur in many otherwise normal males. When the curved penis is small and accompanied by hypospadias, deficiency of prenatal androgen effect can be inferred.
Treatment
The principal treatment of chordee is surgery in infancy, usually by a pediatric urologist.The preferred time for surgery is between the ages of 6 and 18 months, by which time the risk from anesthesia
Anesthesia
Anesthesia, or anaesthesia , traditionally meant the condition of having sensation blocked or temporarily taken away...
is low.
Correction is usually successful.