Penile Chordee
Topic at a Glance
- Penile chordee (a congenital penile curvature) often causes the penis to curve downward during erection.
- Diagnosis is based on physical exam, assessing curvature during erection, and checking for hypospadias.
- In many cases, surgical treatment (chordee repair) can correct the bend, especially in childhood, and preserve sexual function.
- Success rates are high (often 85–100%) for congenital cases, though adult repair is also possible.
Have you noticed a downward bend or curve when the penis is erect? This article explains what penile chordee (a type of penile curvature) is, how doctors diagnose it, and what treatment options exist. You’ll learn signs, causes, and when surgery might be helpful.
At Urology of Greater Atlanta, our experienced urology team treats penile chordee and related conditions across multiple Georgia locations. If you or a loved one suspects penile curvature, contact our offices to discuss evaluation and possible correction.
What is Penile Chordee?
Chordee refers to a penile curvature in which the shaft or head of the penis is bent, most commonly downward (ventrally). It often occurs because tissues on the underside are less elastic than those above. In many cases, chordee is a congenital condition (present at birth).
While some bending of the penis can be within normal variation, severe cases that interfere with sexual activity, cause pain, or impair urinary function may require surgical treatment (chordee repair). Chordee is sometimes associated with hypospadias, where the urethral opening is located on the underside of the penis rather than at the tip.
What Causes Penile Chordee?
Penile chordee can occur either at birth or later due to surgery.
Abnormal Development / Elastic Tissue Differences
The exact reason why chordee occurs is not known. The condition develops as a boy grows in the womb. It is thought that more elastic tissue forms on the top half of the penis than on the bottom half. As the skin is less elastic on the underside of the penis, it will have a downward curve during an erection.
Other possible developmental problems that could result in chordee include:
- Skin tethering or tightness.
- Development of scar tissue in or around the urethra or urinary tube
Chordee hypospadias often develops at the same time. This is when the opening of the urethra is found on the underside of the penis rather than the tip of the penis.
Post-Surgical / Acquired Chordee
Chordee can also occur later, especially after surgery on the penis, such as circumcision. Scar formation, tight skin, or irregular tissue healing can bend the penis over time. The tight skin can curve the head of the penis either upward or downward.
How Do I Know if I Have Chordee?
The presentation of chordee can vary, depending on severity.
- In infants and young children, chordee may be noticed during circumcision or physical exam, especially if hypospadias is also present.
- In older boys or adults (without hypospadias), chordee may go unnoticed until sexual activity begins or an erection reveals the curved penis.
- Symptoms may include pain during erection or intercourse, difficulty with penetration, or discomfort in sexual function.
- In cases with hypospadias, difficulty aiming the urinary stream may be a sign.
- Penile torsion (twisting) may also occur; look for the midline raphe line spiraling around the shaft instead of running straight.
A mild curvature may not cause symptoms or require treatment.
How to Diagnose Chordee
Diagnosis depends on a thorough physical exam:
- Medical History: The doctor inquires about your symptoms, the age of onset, pain, and any prior surgeries.
- Assessment during erection: An erection is induced (pharmacologically or manually) to measure the degree of curvature.
When to Recommend Surgery for Chordee
Not all chordee requires intervention. Treatment is recommended when:
- The curvature is severe and interferes with sexual intercourse or sexual activity.
- There is pain during erection or intercourse.
- Urinary function is impacted (especially in hypospadias cases).
- There are significant concerns about body image.
How is Chordee Repair Performed?
Chordee correction can only be done through surgery. Surgical correction, for those who have developed it at birth, is best performed before age 2. The surgery will straighten the penis.
The procedure can be done as an outpatient surgery. The doctor may ask that the child use a catheter for the first week after surgery.
Chordee repair has very high success rates in childhood. However, surgery in adult men can also be very effective if it is not detected while young.
To correct hypospadias, additional techniques are used to bring the urethral opening to the tip of the penis.
How Successful Is Chordee Repair?
Many studies report success rates between 85% and 100% for congenital cases using modern techniques.
What is Recovery Like After Chordee Repair?
The recovery for chordee repair is usually as follows:
- Most chordee repairs are outpatient or short-stay surgeries.
- A catheter is often used for 1 week post-op.
- Swelling, bruising, and mild discomfort are common initially.
- Sexual activity is usually restricted for four to eight weeks as the tissues heal.
- Long-term follow-up is important, especially through puberty, to monitor for recurrence or changes.
Chordee vs. Peyronie’s Disease
While both conditions involve penile curvature, they differ:
- Chordee is usually congenital (present at birth) or due to surgical scarring, affecting primarily the base or shaft.
- Peyronie’s disease is an acquired condition in adult men, involving scar tissue (fibrotic plaques) inside the penis.
Because of these differences, treatment strategies also differ.
Our Team of Urologists Can Help
If chordee has developed because of a previous circumcision, the team at Urology of Greater Atlanta can perform a circumcision revision.
Apart from penile chordee, our doctors also correct the following concerns:
- A buried penis where there was too much or too little foreskin removed
- A thickening of the foreskin (skin bridge)
- A narrowing of the opening at the end of the penis (meatal stenosis)
Call our office or book online to speak with our urologists. Our urologist team offers expert patient care and operates out of several offices and a surgical center to serve the needs of all Northern Georgia residents.
FAQs About Penile Chordee
Can chordee correct itself over time?
Mild curvature sometimes improves during infancy or early growth, but spontaneous resolution is rare for moderate or severe bends. Close monitoring is essential.
At what age is chordee repair optimal?
For congenital cases, repair is often done before 1–2 years of age to reduce psychological impact and maximize function. However, surgery in adulthood can still be effective.
Will surgery affect penis length or sexual function?
Some shortening may occur. But most patients retain good erectile and sexual function with proper repair.
How long is recovery, and when can intercourse resume?
Initial healing takes a few weeks; doctors typically recommend waiting 4–8 weeks (or longer) before sexual activity, depending on individual healing.
Is chordee treatment safe, and what are the risks?
Chordee repair is generally safe, with low complication rates (The Journal of Urology cited 8% in one of their reports). Risks include residual curvature, recurrence, or urethral complications.
What if I am embarrassed to have this exam?
Our professionals have many years of experience and have seen it all, so there is no need to feel embarrassed. Their main focus is to help you by locating any medical abnormalities.
