Sometimes an otherwise completely normal penis is twisted to the side, usually to the child’s left as seen in the photographs. If not corrected the boy will often urinate to the left and may have to twist his body or his penis in order to urinate straight into the toilet. Straightening the twist requires a minor operation called a phalloplasty. If the twist was noticed prior to circumcision and the family desires one, it can be performed at the same time when the torsion is straightened. If the family prefers the appearance of a natural, uncircumcised penis, the torsion can be corrected through the natural line at the 6 o’clock position along the penis called the median raphe, preserving the foreskin. The goal of surgery is to correct the urinary opening so that it points toward the 6 o’clock position instead of the 3 o’clock position.
Torsion of the head of the penis shown in 2 patients (A, B).