Erectile deformity

Summary: Urological referral not indicated for most patients

Advice: Urological referral is NOT indicated for the majority of patients. Difficulty obtaining/maintaining an erection or deformity which prevents penetration and sexual intercourse may be indications for referral.
Refer To: Any adult urologist


Commonest causes

Peyronie’s disease
This is the commonest cause of erectile deformity; referral is usually unnecessary and is now actively discouraged. Please use the information sheet on Peyronie’s disease (see below) as an aid to explanation in anxious patients or see the guideline section on Peyronie’s disease. Referral is needed only for patients in whom the erectile deformity prevents penetration or ereection, when the disease has been stable (not progressing) for a minimum period of 6 months.

Short penile frenulum
This is usually obvious on simple examination and should be referred for consideration of frenuloplasty or, in severe cases, circumcision.

Traumatic cavernous fibrosis
This is caused by non-disruptive coital trauma and may cause erectile pain and/or deformity; referral should be considered.

Tethered penis and buried penis
These conditions usually present in childhood and are very rare in adults.

Pain on erection as a result of urethral inflammation
This should be managed by referral to the GenitoMedical Clinic (Clinic 1A).

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