Penis Curvature in Hypospadias vs. Isolated Penis Curvature
Left picture: In this case a typical curvature combined with a hypospadias is present; it occurs often in severe types of hypospadias. Right picture: The diagnosis is an isolated curvature of the penis without a recognizable hypospadias. For this differential diagnosis the following abnormalities of the local findings are useful: Left picture: A prepuce is not recognizable on the ventral side, but there is a surplus of the visible part of the foreskin on the dorsal side, forming a ridge like a cape. Besides the external urethral orifice which is displaced in a ventral and proximal direction, the described elements are characteristic; compare them with the figure at the bottom with a ventral view of the penis of another patient with nearly identical findings . Right picture: Here, the described elements are missing; therefore, the terms ´penis curvature without hypospadias´ or ´isolated penis curvature´ are used. Left picture: On close inspection it becomes obvious that a penis curvature can consist of several elements (listed from periphery in a central direction): 1) tilted glans; 2) penis shaft curvature; 3) skin fold at the base of the penis (webbed penis, palmure of the penis).
Left picture: Lateral view of a penis in a toddler. The penis describes a severe curvature of the longitudinal axis in the sagittal plane in a ventral direction. Right picture: Toddler with a curvature of the longitudinal axis in the ventral direction which is at first sight not striking; however, it becomes obvious by an artificial erection in general anesthesia prior to surgery in the additional picture at the bottom; compare it with the figure at the top of the same patient.