Saxophone penis is a term used when the penis bends along its long axis, which leaves swollen and twisted penis resembling a saxophone. The bending of the penis may be caused by bacterial infection (Lymphogranuloma venereum caused by Chlamydia) or blocked lymph nodes (lymphoedema). Although there may not be difficulty in urinating but sex may be very difficult or almost impossible.
The exact cause and mechanism of such deformity is not known, however, the most likely explanation describes long-standing inflammation of the penis leading to fibrosis of the lymphatics and the surrounding connective tissues on the dorsal side of the penis. As a result, the ventral side which has high blood supply gets edematous (swells) which pushes the glans penis upwards and bends dorsally thus leads to classical saxophone penis.
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There is no effective treatment for Saxophone penis; however long-term oral drugs can help with the swelling and twisting. Surgical modalities may include lymphangioplasty or Lymphangiectomy with reconstructive surgery to correct the defect.