What is the medical term for a curved newborn penis shaft?

Medical Term for Curved Newborn Penis Shaft

The medical term for a curved newborn penis shaft is chordee, which is a congenital penile curvature that often occurs in association with hypospadias but can also present as an isolated finding.

Understanding Chordee in Newborns

Chordee is characterized by an abnormal downward (ventral) curvature of the penis. This condition can present with varying degrees of severity:

• Mild: Slight curvature with minimal functional impact
• Moderate: Noticeable curvature that may require intervention
• Severe: Significant curvature that can interfere with normal urinary function

Association with Hypospadias

Chordee frequently occurs alongside hypospadias, which is a congenital condition where the urethral opening is located on the underside of the penis rather than at the tip. According to research:

• Hypospadias occurs in approximately 1 in 125-200 live male births 1
• Penile curvature (chordee) is particularly common in proximal forms of hypospadias 2
• Even in distal (milder) forms of hypospadias, chordee may be present but sometimes goes undiagnosed if not specifically tested for during examination 2

Diagnosis

The diagnosis of chordee in newborns involves:

1. Physical examination: Careful assessment of the penis to identify the degree of curvature
2. Evaluation of associated anomalies: Checking for hypospadias, cryptorchidism, or other genital abnormalities

Important Clinical Considerations

• Providers should not perform ultrasound or other imaging modalities in the initial evaluation as these rarely assist in decision making 3
• If chordee is associated with hypospadias, circumcision should be avoided as the foreskin tissue may be needed for surgical repair 1
• In cases where chordee is accompanied by bilateral nonpalpable testes, immediate specialist consultation is required to evaluate for possible disorders of sex development 3

Management

Management of chordee depends on severity and associated conditions:

1. Referral timing: Newborns with chordee, especially when associated with hypospadias, should be referred to a pediatric urologist as early as possible 1

2. Surgical correction:

   • For isolated chordee or chordee with hypospadias, surgical repair is typically performed between 6-12 months of age 4
   • The goal of surgery is to achieve both functional and cosmetic normalization 5

3. Special considerations:

   • If chordee is associated with a penoscrotal web (skin connecting the penis to the scrotum), modified circumcision techniques with oblique incision may be successful in 99% of cases, potentially avoiding more extensive surgical reconstruction 6

Long-term Outcomes

With appropriate and timely management:

• Most cases can be repaired in a single operation 4
• Even with less than perfect surgical results, patients typically enjoy satisfactory sexual function later in life 4
• Early intervention helps minimize psychological impact on the child 5

Important Cautions

• Never circumcise a newborn with chordee and hypospadias before urological evaluation, as the foreskin tissue may be needed for surgical repair
• Regular follow-up is essential to monitor for any complications or recurrence of curvature during growth
• Parents should be counseled about the condition and reassured about the generally good outcomes with appropriate treatment