Penile Curvature After Trauma: Causes and Treatment Options - Urology

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Penile curvature and associated symptoms following trauma can be concerning and may indicate underlying injuries to the penile structures, including the corpus cavernosum, corpus spongiosum, and surrounding vascular and nerve tissues. Based on your description, it appears that you have experienced significant trauma to the area, resulting in bruising and altered urinary function.

Causes of Penile Curvature After Trauma
1. Trauma to the Corpora Cavernosa: The corpus cavernosum is responsible for penile rigidity during an erection. Trauma can lead to hematomas (localized bleeding outside of blood vessels) or even fractures of the erectile tissue, which can result in curvature or deformity during erection.

2. Injury to the Corpus Spongiosum: This structure surrounds the urethra and is crucial for maintaining the shape of the penis during erection. Damage here can lead to issues with urination and may contribute to curvature.

3. Vascular Damage: Injury to the blood vessels supplying the penis can lead to inadequate blood flow, resulting in erectile dysfunction or curvature. If the blood supply is compromised, it may affect the ability to achieve or maintain an erection.

4. Nerve Damage: The nerves that innervate the penis can also be affected by trauma. Damage to these nerves can lead to altered sensation, erectile dysfunction, or changes in curvature.


Symptoms and Diagnosis
The symptoms you describe—curvature during urination, the need to manually adjust the penis to achieve a straight position, and the presence of bruising—suggest that there may be structural damage. The fact that you have undergone ultrasound imaging is a positive step, as it can help visualize any hematomas or structural abnormalities.


Treatment Options
1. Observation: If the curvature is mild and does not significantly impact function, some doctors may recommend a period of observation. Many cases of penile trauma can resolve on their own over time.

2. Medication: You mentioned being prescribed medications such as "合利他命F50" (likely a vitamin supplement) and "暢循持續性膜衣錠400mg" (possibly a circulation enhancer). While these may not directly address structural issues, they could help improve blood flow and overall healing. If these medications are ineffective, it may be worth discussing alternative treatments with your physician.

3. Physical Therapy: Pelvic floor physical therapy may help improve function and reduce curvature by strengthening the surrounding muscles and improving blood flow.

4. Surgical Intervention: In cases where there is significant curvature or if conservative measures fail, surgical options may be considered. Procedures can include plication (surgical shortening of the longer side of the penis) or grafting techniques to correct curvature.

5. Counseling: Psychological support may also be beneficial, especially if the trauma has led to anxiety or distress regarding sexual function.


Conclusion
It is crucial to maintain open communication with your healthcare provider regarding your symptoms and treatment options. If you feel that your concerns are not being adequately addressed, seeking a second opinion from a urologist who specializes in penile trauma may provide further insights and treatment options. Additionally, ensure that any new symptoms or changes in your condition are reported promptly to your healthcare provider for appropriate management.