Erections Pointing Left/Right of Center
Normally, when the penis is erect and rigid, it will be point forward, upward, and toward the center. However, it is not uncommon for some men to notice that the penis points to the left or the right.
Curvatures of the penis can orient an erect penis to the left of right; however, in this section we will deal primarily with deviations that are not due to curvatures.
Left or Right of Center
Many men, if not most will have a penis that is points close to center (in line with the belly button). This slight pointing to one side or another can be seen as well in men with slight lateral curvatures of the penis. Deviations greater than 20 degrees are often associated with lateral curvatures of the penis and correcting the curvature also corrects the orientation of the erection.
However, when there is no curvature and the penis is points to the left of right, the condition is called Lateral Deviation of the Erect Strait Penis or LDESP. In most cases, LDESP does not warrant surgical correction, especially if the deviation is less than 20 degrees from center (see figure below). The reason surgery often isn’t warranted is because in the majority of cases, the penis can be manually pointed towards center to engage in sexual activity without causing discomfort. In addition, sexual activity often keeps the penis in the midline. In fact, over 90% of men who simply receive counseling and reassurance about LDESP require no treatment and can have sexually fulfilling lives.[i]
This pointing away from center is usually caused when the skin on one side of the base of the penis is looser than the other side – causing the penis to draw to the side with the tighter skin (if the skin on the left side is tighter, the penis will point slightly to the left). Many men notice that the penis will push to one side or the other in the beginning stages of an erection then center up when the penis becomes rigid. This can simply be caused by one of the corpus cavernosa (erectile columns) filling earlier or faster than the other cavernosa. This is not a need for concern and is actually very common.
However, some men have significant LDESP where deviations are 45 degrees or more Below is shown a 45 degree deviation.
A significant LDESP deviation may cause sexual issues. In cases where sexual activity is difficult or painful due to the deviation, skin reduction technique (SRT) can be used to help pull the erection more to the center. SRT involves cutting excess skin from the side of the penis that is loose and stitching the skin back together to make it more tight. This then pulls the erection back towards center. One study found that this surgery works in 80% of men, while 20% will have the LDESP re-occur later on.[i]
[i] (Shaeer O. Skin reduction technique for correction of lateral deviation of the erect straight penis. J Sex Med 2014;11:1863–1866. (https://www.ncbi.nlm.nih.gov/pubmed/24628881) 3/18/17 & Andrology for the Clinician
edited by Wolf-Bernhard Schill, Frank H. Comhaire, Timothy B. Hargreave page 95 (https://books.google.com/books?id=5Ts_AAAAQBAJ&pg=PA95&lpg=PA95&dq=Lateral+deviation+of+the+erect+penis&source=bl&ots=0Uin_6zXcS&sig=HhassaCUTlLbBVfDl5y12sj_YkU&hl=en&sa=X&ved=0ahUKEwiOs7fNrODSAhVHzmMKHYTPC8AQ6AEIQTAH#v=onepage&q=Lateral%20deviation%20of%20the%20erect%20penis&f=false) 3/18/17
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