Management of penile emergencies- one year observation
DOI:
https://doi.org/10.18203/2349-2902.isj20211803Keywords:
International index of erectile function, Penile injuries, PriapismAbstract
Background: Penis is a very sensitive organ and even minor injury or discomfort may cause a patient to seek emergency evaluation. Penile emergencies and their management often rely on the results of imaging examinations. But most of the time the traumatic emergencies require urgent exploration to ensure a fair outcome. Objective was to present different types of penile emergencies and to determine the overall outcome of their managements.
Methods: It was an observational study conducted at surgery department of Enam Medical College and Hospital, for one year. All patients with penile emergencies were included by selective sampling technique. The main outcome variables were type of penile emergencies, etiology of trauma, grading of trauma, types of surgical intervention, postoperative erectile function. Data processing and analysis were done using SPSS v (23). Statistical significance was determined by Students t test for quantitative data.
Results: Total 33 patients admitted with emergencies. 18 (54.5%) belonged to traumatic category, 10 (30%) belonged to infective and one patient (3%) belonged to vascular (ischemic priapism) and others consist of 4 (12%). 40% of trauma was of grade III variety. Seven were victim of sharp cut injury. One who presented with ischemic priapism after 3 days underwent emergency distal shunt procedure with an acceptable functional penis post operatively. Timing of surgical intervention was compared with erectile function on the basis of International Index of Erectile Function (IIEF). A p value <0.05 was considered to be significant.
Conclusions: Penile emergencies require prompt, accurate diagnosis. Early surgical intervention can save the organ.
References
Eke N. Fracture of penis. Br J Surg. 2002;89(5):555-65
Penson DF, Seftel AD, Krane RJ, Frohrib D, Goldstein I. The hemodynamic pathophysiology of impotence following blunt trauma to the erect penis. J Urol. 1992;148(4):1171-80.
Aaronson DS, Shindel AW. U.S. national statistics on penile fracture. J Sex Med. 2010;7(9):3226.
Reddy SVK, Shaik AB, Sreenivas K. Penile injuries: a 10-year experience. Can Urol Assoc J. 2014;8(9-10):E626-31.
Moon SJ, Kim DH, Chung JH, Jo JK, Son YW, Choi HY, et al. Unusual foreign bodies in the urinary bladder and urethra due to autoerotism. Int Neurourol J. 2010;14:186-9.
Perovic SV, Djinovic RP, Bumbasirevic MZ, Santucci RA, Djordjevic ML, Kourbatov D. Severe penile injuries: a problem of severity and reconstruction. BJU Int. 2009;104:676-87.
Wyatt JP, Scobie WG. The management of penile zip entrapment in children. Injury. 1994;25(1):59-60.
Nolan JF, Stillwell TJ, Sands JP Jr. Acute management of the zipper-entrapped penis. J Emerg Med. 1990;8(3):305-7.
Sadeghi-Nejad H, Dogra V, Seftel AD, Mohamed MA. Priapism. Radiol Clin North Am. 2004;42(2):427-43.
Tay YK, Spernat D, Rzetelski-West K, Appu S, Love C. Acute management of priapism in men. BJU Int. 2012;109(Suppl 3):15-21
Fernandes MAV, Souza LRMF, Cartafina LP. Ultrasound evaluation of the penis. Radiol Bras. 2018;51(4):257-61.
Edwards SK, Bunker CB, Ziller F, van der Meijden WI. 2013 European guideline for the management of balanoposthitis. Int J STD AIDS. 2014;25(9):615-26.
Bilsch M, Kromonn-Andersen B, Schou J, Sjøntoft E. The elasticity and the tensile strength of the tunica albuginea of the corpora cavernosa. J Urol. 1990;143(3):642-5.
Agarwal MM, Singh SK, Sharma DK, Ranjan P, Kumar S, Chandramohan V, et al. Fracture of the penis: a radiological or clinical diagnosis? A case series and literature review. Can J Urol. 2009;16(2):4568-75.
Zargooshi J. Penile fracture in Kermanshah, Iran: report of 172 cases. J Urol. 2000;164(2):364-6.
Feather NT. Domestic violence, gender, and perceptions of justice. Sex roles. 1996;35(7-8):507-19.
Van der Horst C, Stuebinger H, Seif C, Melchior D, Martenez-Portillo FJ, Juenemann KP. Priapism- etiology, pathophysiology and management. Int Braz J Urol. 2003;29(5):301-400.
El-Bahnasawy MS, Dawood A, Farouk A. Low-flow priapism: risk factors for erectile dysfunction. BJU Int. 2002;89(3):285-90.
Tal R, Valenzuela R, Aviv N, Parker M, Waters WB, Flanigan RC, et al. Persistent erectile dysfunction following radical prostatectomy: the association between nerve-sparing status and the prevalence and chronology of venous leak. J Sex Med. 2009;6(10):2813-9.
