EAU guidelines on penile curvature.

Area of Science:

• Urology
• Andrology
• Medical Guidelines

Background:

• Penile curvature can be congenital or acquired, with acquired cases often linked to La Peyronie disease.
• The exact pathogenesis of congenital penile curvature remains unknown.
• Peyronie's disease is a connective tissue disorder potentially caused by trauma, leading to penile deformity.

Purpose of the Study:

• To establish clinical guidelines for the diagnosis and management of penile curvature.
• To synthesize current evidence on treatment options for congenital and acquired penile curvature.

Main Methods:

• A systematic literature search was conducted to gather data on penile curvature.
• Articles with the highest levels of evidence were selected to inform recommendations.
• Evidence levels and recommendation grades were assigned based on the reviewed literature.

Main Results:

• Diagnosis of penile curvature relies on medical history, sexual history, and physical examination, with imaging (self-photograph or pharmacologically induced erection) aiding documentation.
• Congenital penile curvature is treated surgically using plication techniques.
• For Peyronie's disease, conservative treatments show poor outcomes; pharmacotherapy options exist but lack Grade A recommendations. Surgery is indicated for stable disease, with plication techniques preferred for tunical shortening, while lengthening procedures address severe deformities. Penile prosthesis is recommended for erectile dysfunction unresponsive to other treatments.

Conclusions:

• These guidelines from the European Association of Urology (EAU) summarize current knowledge on penile curvature.
• The comprehensive guidelines are available on the EAU website.