chordee

It is usually considered a congenital malformation of unknown cause. Since at an early stage of fetal development the penis is curved downward, it has been proposed that chordee results from an arrest of penile development at that stage.{{cn|date=May 2021}}

The curvature of a chordee can involve{{cn|date=May 2021}}

1. tethering of the skin with urethra and corpora of normal size;
2. curvature induced by fibrosis and contracture of the fascial tissue (Buck's fascia or dartos) surrounding the urethra;
3. disproportionately large corpora in relation to the urethral length without other demonstrable abnormality of either; or
4. a short, fibrotic urethra that tethers the penis downward (the least common type).

Severe degrees of chordee are usually associated with hypospadias, but mild degrees of curvature may occur in many otherwise normal males. When the curved penis is small and accompanied by hypospadias, deficiency of prenatal androgen effect can be inferred. {{Citation needed|date=March 2016}}

A chordee may be caused by an underlying condition, such as a disorder of sex development or an intersex condition, or from a complication of circumcision,{{Citation | doi = 10.1542/peds.103.3.686 | title = AMERICAN ACADEMY OF PEDIATRICS: Circumcision Policy Statement | date = 3 March 1999 | journal = Pediatrics | volume = 103 | issue = 3 | pages = 686–693 | pmid = 10049981 | doi-access = }}{{Citation | last = Kaplan, MD | first = George W | title = Complications of Circumcision | date = August 1983 | url = http://www.cirp.org/library/complications/kaplan/ | journal = Urologic Clinics of North America | volume = 10 | issue = 3 | pages = 543–549| doi = 10.1016/S0094-0143(21)01717-1 | pmid = 6623741 | url-access = subscription }} though some medical professionals do not consider it to be true chordee because the corporal bodies are normally formed.{{Cite web | title=Complications of Circumcision | url=http://newborns.stanford.edu/CircComplications.html |access-date = 19 August 2010 }} However, not all congenital chordee includes abnormal corpora, and case reports of damage to the corpus cavernosum from circumcision are noted in the literature; particularly as a complication of local anesthetic.{{Citation | doi = 10.1001/jama.241.24.2635 | last1 = Palmer, MD | first1 = John M | last2 = Link, MD | first2 = Daniel | title = Impotence Following Anesthesia for Elective Circumcision | journal = Journal of the American Medical Association | volume = 241 | issue = 24| pages = 2635–2636 | date = June 15, 1979 | orig-year = 1979 | url = http://www.cirp.org/library/complications/palmer/ | pmid = 439362 | url-access = subscription }}

The principal treatment of chordee is surgery in infancy,{{Citation |vauthors=Braga LH, Pippi Salle JL, Dave S, Bagli DJ, Lorenzo AJ, Khoury AE |title=Outcome analysis of severe chordee correction using tunica vaginalis as a flap in boys with proximal hypospadias |journal=J. Urol. |volume=178 |issue=4 Pt 2 |pages=1693–7; discussion 1697 |year=2007 |pmid=17707021 |doi=10.1016/j.juro.2007.03.166 |postscript=.}} usually by a pediatric urologist. With chordees caused by circumcision, the preferred method of surgical treatment is a z-plasty.Kaplan GW. Complications of circumcision. Urol Clin N Amer 1983;10:543-9. The preferred time for surgery is between the ages of 6 and 18 months and correction is usually successful.{{cn|date=May 2021}}

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| DiseasesDB =

| ICD10 = {{ICD10|N|48|8|n|40}} (ILDS N48.83), {{ICD10|Q|54|4|q|50}}

| ICD9 = {{ICD9|752.63}}

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{{Male congenital malformations of genital organs, indeterminate sex and pseudohermaphroditism}}

Category:Congenital disorders of male genital organs

Category:Penis disorders