Erection Rotations

Slight rotation or twisting of the penis is not uncommon and most men probably know if they rotate slightly clockwise or counter-clockwise.  As many as 27 percent of men have a slight twisting of the penis.[i]  Normally, the penile raphe (ridge of skin) should run along the entire underside of the penis in a straight line.  This typically results in the raphe lying on the scrotum when the penis is flaccid.  Any rotation of the penis is called torsion.  Torsion occurs when the penis rotates, usually counter-clockwise along the shaft. 

 

Mild twists are considered any twisting less than 45 degrees, moderate twists are 45-90 degrees with severe twists being greater than 90 degrees.  A 90 degree torsion would have penis lying on its side when flaccid.  It is estimated that only 0.7% of males have a severe penile torsion.[i]  Click HERE to see an example of a 90 degree torsion.  A 180 degree rotation results in the glans being “upside down” with the frenulum facing up.   Below is a rough illustration of torsion as viewed looking down on the glans of the penis with the underside of the glans (coronal sulcus/frenulum area) facing down.

Torsion.jpg

Since torsion is most often caught at birth, most of these surgeries are performed in babies.  When a curvature is also present, the erect penis often has a corkscrew appearance.

[i] Bhat A, Correlation of severity of penile torsion with type of hypospadias & ventral penile curvature and their management. African J of Uro 21(2), 2015, 111-8.

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