Chordee

Overview

Chordee is a congenital condition in which the penis curves downward, typically noticeable during an erection. This condition often accompanies hypospadias, where the urethral opening is located on the underside of the penis rather than at the tip. Chordee can affect urination and sexual function if left untreated.

Chordee has been recognized for centuries. Early medical literature often referred to it in the context of hypospadias repair. The understanding and treatment of chordee have advanced significantly over time. Urologists and pediatric surgeons have developed more refined methods to correct the curvature, allowing for better functional and cosmetic outcomes.

Causes

Chordee is a congenital condition, meaning it is present at birth. The exact cause is not well understood but is thought to result from abnormal development of the penile tissue during fetal growth. It often occurs in conjunction with hypospadias but can also appear independently.

Risk Factors

Several factors may increase the risk of chordee, including:

• Family history of chordee or other congenital penile abnormalities.
• Genetic factors influencing fetal development.
• Environmental factors during pregnancy, though specific factors are not well defined.
• Assisted reproductive technologies (ie fertility treatments)

Complications

If left untreated, chordee can lead to several complications:

Urinary Issues: Difficulty urinating due to the abnormal position of the urethral opening.

Sexual Dysfunction: Pain or difficulty during erections, which can affect sexual function later in life.

Psychological Impact: Concerns about the appearance of the penis and related emotional distress.

Circumcision complications: Traditional newborn circumcision is more likely to have complications if chordee is present.

Prevention

Since chordee is a congenital condition, there are no specific preventive measures beyond routine prenatal care. Early diagnosis after birth can allow informed decision making, particularly to avoid complications during newborn circumcision. Though not all patients with chordee require surgery, there are advantages to early/timely intervention.