Chordee occurs in 1 out of every 200 male births. We’ll explain everything you need to know about this fairly common birth defect.
What is chordee?
Chordee is an abnormal congenital penile curvature, where the penis shows a downward or sideways curvature or a combination of both. This penile torsion is more easily seen when the penis is erect. Chordee is a congenital condition.
Let’s first explain what ‘dorsal’ and ‘ventral’ mean when referring to the penis.
In the penis, the dorsal part is the part at the top if you hold the penis horizontally.
The ventral part of the penis would then be the underside of the penis, when held horizontally.
What is Hypospadias?
Hypospadias is an abnormal development of the urethral opening in baby boys. Hypospadias means that the urethral opening is not at the tip of the penis. Although chordee and hypospadias are frequently seen together, a man can have chordee without hypospadias and can have hypospadias while being chordee free.
Hypospadias can be ventral or dorsal, depending on where in the penis the urethra opens.
Hypospadias with chordee
When there is penile torsion (chordee) it is quite common that the cause of the abnormal penile curvature also pushes the urinary opening sideways from the tip of the penis. It might be necessary to correct hypospadias surgically, because of the possibility of complications later in life. Chordee and hypospadias surgeries have a high chance of success.
Some hypospadias might not interfere with a boy’s life; more severe hypospadias can have a negative impact, if not corrected.
Some of the possible complications of untreated hypospadias are:
- Abnormal appearance of the penis
- Difficulties in learning how to use the toilet. Difficulties might also arise when trying to urinate while standing
- Abnormal curvature of the penis with erection
- Impaired sexual function. Hypospadias can inhibit sexual function and cause a real burden during normal sexual activity. It can affect intercourse and ejaculation.
Not all hypospadias need surgical correction.
Talk to a pediatric urologist (or more than one) who will be able to assess your child’s case individually and advise you about the best options for him.
You can read more about hypospadias in What Is Hypospadias? All You Need To Know.
Chordee – causes
There hasn’t been a great deal of research into what causes chordee.
As the baby’s penis develops in utero, more elastic tissue develops in the upperside than in the underside of the penis; this results in a curved penis, which is especially obvious when the penis is erect.
Problems with the urethra might also be among the causes of penile chordee.
Sometimes, skin tethering in the lower part of the penis can also cause chordee.
A specialized doctor should see your baby and perform a physical exam, to diagnose chordee, assess the potential risks and decide on the best treatment. Although surgical treatment is recommended – and is common – it isn’t always the best option. Some adults’ penile curvature chordee simply means that have an unusual-looking erect penis.
Living with chordee
Many infants grow up with chordee and it doesn’t have a big influence on their future sexual life.
For some children and men, it is a struggle to live with chordee.
Let’s look at what it means to live with chordee at different life stages.
Chordee in an infant
When chordee is suspected in an infant, it’s important that a specialized doctor (a pediatric urologist) assesses your baby’s penile chordee. An individualized assessment is of paramount importance; nobody would like a child to go through chordee surgery if it’s not 100% necessary.
If the child has hypospadias as well, then doctors tend to recommend surgery. Both surgeries – hypospadias and chordee – tend to be done together in the same procedure. This means the little patient has to go through recovery just once.
Chordee in adulthood
If you have managed to get to adulthood with chordee, it is because probably it hasn’t caused you much trouble.
Mild cases of chordee have very little effect on your penile function.
In some cases, a man doesn’t experience any problems with chordee until he starts to have an active sexual life and realizes there might be a problem. He might then seek treatment.
If this is your situation, then look for a urologist who will study your case and advise you on your treatment options.
Remember that you can seek a second opinion if you disagree with your doctor’s perspective or if you prefer to ask several professionals before you have surgery on your penis.
Can chordee correct itself?
As chordee is a congenital condition (you are born with it), it doesn’t correct itself. However, some men can lead a perfectly normal life without surgery.
Your case should be evaluated carefully. All your options, the related risks, as well as alternatives, should be presented and discussed with you, so you can make an informed decision.
Does chordee need to be corrected?
If chordee is bothering you, you should have it examined and treated. If it isn’t causing you any major complications, it might be a good idea to leave the area around the penis free of scar tissue.
Only you can make the decision about which option is best for you.
If you experience pain, bladder spasms or any other signs related to chordee, then of course it’s important to correct chordee with surgery.
It is also important to refrain from performing circumcision in a child if a chordee is suspected, as the foreskin will have a pivotal role in chordee repair.
In this type of surgery, the doctor aims to make the shorter and longer sides of the penis equal, to straighten the penis when it’s erect.
There should be no rush to perform chordee surgery, unless it’s affecting the child’s quality of life. When the decision for surgery has been made, the sooner it is performed, the better.