Penile Rotation: Causes and Treatment Options

Q: Penile Rotation: Causes and Treatment Options

Hello Mr. <br>Li： Based on what you described, it is possible that you have penile curvature, which could also be caused by phimosis. <br>Masturbation and the varying lengths of the foreskin are theoretically unrelated unless there is "recurrent inflammation." Additionally, you h

Counterclockwise rotation of the penis and glans?

Hello, doctor.
Two years ago, I finally managed to retract my foreskin.
Initially, there were no issues, but I have one problem: occasionally, the foreskin retracts on its own due to sensitivity and gets stuck at the coronal sulcus, requiring manual adjustment to push it back.
Last year, I visited a urologist because I suspected a varicocele on the left testicle, which was causing a dull ache, and my glans was also uncomfortable.
After applying some medication, it improved.
The doctor mentioned it could be related to the varicocele, and upon examination, there were no significant issues; he advised me to maintain cleanliness and to retract the foreskin while urinating.
However, this year, I've noticed that the left side of the foreskin is shorter and thinner, while the right side is longer and thicker.
Additionally, the glans appears to be rotated about 15 degrees towards the side with the shorter foreskin (when viewed from above).
The left testicle is also positioned slightly more anteriorly than the right when erect, and the angle of inclination seems to match the rotation.
Recently, I've observed that this condition seems to be worsening, and there appears to be a general twisting of the penis (though the frenulum and foreskin still appear perpendicular to the ground).
During erection, the left side feels tighter, but it's not uncomfortable, and urination is normal.
I'm concerned that the angle is increasing.

Could this be caused by the uneven length of the foreskin, or is it due to excessive masturbation (almost daily)? I’m worried that the angle seems to be worsening.
What should I do about this? I'm concerned that surgery might be the only solution, but I'm hesitant to seek medical attention.

Mr. Li, 20~29 year old female. Ask Date: 2023/12/14

Dr. Sun Hongshun reply Urology

Hello Mr.
Li: Based on what you described, it is possible that you have penile curvature, which could also be caused by phimosis.
Masturbation and the varying lengths of the foreskin are theoretically unrelated unless there is "recurrent inflammation." Additionally, you have a problem with varicocele, so I recommend seeking medical attention to receive the best care.

Reply Date: 2023/12/14

More Info

Understanding penile rotation and its potential causes is essential for addressing your concerns. Based on your description, it seems you are experiencing a condition where the penis appears to rotate or tilt due to differences in the length and thickness of the foreskin on either side. This can lead to a noticeable angle when the penis is erect, which you have observed to be increasing over time.

Causes of Penile Rotation
1. Anatomical Variations: The differences in the length and thickness of the foreskin can create an imbalance. If one side of the foreskin is shorter or thinner, it may not retract as easily during an erection, leading to a rotational effect. This is similar to how uneven tension on a rope can cause it to twist.

2. Tethering Effects: The frenulum, which is the band of tissue on the underside of the penis, plays a crucial role in the retraction of the foreskin. If the frenulum is tight or if the foreskin is unevenly distributed, it can contribute to the rotation.

3. Overuse or Trauma: Frequent manual stimulation, as you mentioned, can lead to changes in the tissue elasticity and may contribute to the development of conditions like Peyronie's disease, which is characterized by curvature of the penis due to fibrous scar tissue. While you haven't mentioned any pain or discomfort, it's important to monitor any changes.

4. Underlying Conditions: Conditions such as varicocele (which you mentioned) can sometimes lead to discomfort or changes in the anatomy of the scrotum and penis, although they are not directly related to penile rotation.

Treatment Options
1. Observation: If the rotation is not causing pain or significant discomfort, and if urination and sexual function remain normal, your doctor may recommend simply monitoring the situation. Changes in the angle may stabilize over time.

2. Physical Therapy: Some men find that gentle stretching exercises can help alleviate tightness in the frenulum or foreskin. However, this should be done cautiously and ideally under the guidance of a healthcare professional.

3. Surgical Options: If the rotation becomes more pronounced or starts to cause discomfort, surgical options may be considered. These can include:
- Frenuloplasty: To lengthen a tight frenulum.

- Circumcision: If the foreskin is causing recurrent issues, complete removal may be recommended.

- Penile Reconstruction: In cases of significant curvature or rotation, more complex surgical options may be necessary.

4. Consultation with a Urologist: It is crucial to consult a urologist who specializes in male reproductive health. They can provide a thorough examination and discuss the best course of action based on your specific situation. They can also address any concerns about the potential impact of your habits on your penile health.

Conclusion
While it is understandable to feel apprehensive about seeking medical advice, addressing these concerns with a healthcare professional is important for your overall health and well-being. Early intervention can prevent potential complications and provide peace of mind. Remember, many men experience variations in anatomy, and healthcare providers are trained to help you navigate these issues sensitively and effectively.

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