Our experience with the management of penile fracture: a single institutional prospective observational study in eighteen patients over a two-year period
DOI:
https://doi.org/10.18203/2349-2902.isj20212712Keywords:
Curvature, Erectile dysfunction, Fracture, Nodule, Penis, SurgeryAbstract
Background: Penile fracture is a not an unusual encounter in urological emergency. The condition results from disruption of the tunica albuginea which envelops the corpora cavernosa as a result of any condition which leads to the sudden rise of intra-cavernosal pressure. The study was designed to analyse the clinical spectrum and complication of penile fracture.
Methods: This is a prospective observational study undertaken from April, 2019 to March, 2021on 18 patients. The demographic profile of all the patients, aetiology of penile fracture, management strategies and pre-operative sexual functions were documented. Erectile function was evaluated using international index of erectile function (IIEF).
Results: Seventeen out of 18 patients (94.44%) gave a history of injury during sexual intercourse. Out of the seventeen patients with history of injury following sexual intercourse, only 9 (52.94%) were married. 15 (93.75%) had disruption of the tunica albuginea in the ventrolateral position with 10 patients (66.66%) on the right side. Patients were followed up in the OPD after 2 weeks and then at 6 month and 1-year intervals. At 12 months postop, none of the patients complained of sexual inactivity. Average time to return to sexual activity was 3.2 months. Two patients complained of penile curvature >20 degree. Six patients complained of penile nodule at the site of repair.
Conclusions: Penile fracture is a urological emergency which is primarily diagnosed clinically. Prompt diagnosis and surgical exploration gives good outcome in terms of preservation of sexual function.
Metrics
References
Amer T, Wilson R, Chlosta P, AlBuheissi S, Qazi H, Fraser M et al. Penile fracture: A meta-analysis. Urol Int. 2016;96:315-29.
Asgari MA, Hosseini SY, Safarinejad MR, Samadzadeh B, Bardideh AR. Penile fractures: Evaluation, therapeutic approaches and long-term results. J Urol. 1996;155:148-9.
Lee SH, Bak CW, Choi MH, Lee HS, Lee MS, Yoon SJ. Trauma to male genital organs: A 10-year review of 156 patients, including 118 treated by surgery. BJU Int. 2008;101:211-5.
Hsu GL, Brock G, Martínez-Piñeiro L, Von Heyden B, Lue TF, Tanagho EA. Anatomy and strength of the tunica albuginea: Its relevance to penile prosthesis extrusion. J Urol. 1994;151:1205-8.
Koifman L, Barros R, Júnior RA, Cavalcanti AG, Favorito LA. Penile fracture: Diagnosis, treatment and outcomes of 150 patients. Urology. 2010;76:1488-92.
Özen HA, Erkan I, Alkibay T, Kendi S, Remzi D. Fracture of the penis and long-term results of surgical treatment. Br J Urol. 1986;58:551-2.
Morey AF, Dugi DD 3rd. Genital and lower urinary tract trauma. In: Wein AJ, Kavoussi LR, Partin AW, Novick AC, editors. Campbell-Walsh Urology. 10th ed. Philadelphia: Elsevier-Saunders, Co. 2012;2507-20.
Jack GS, Garraway I, Reznichek R, Rajfer J. Current treatment options for penile fractures. Rev Urol. 2004;6:114-20.
Zargooshi J. Penile fracture in Kermanshah, Iran: Report of 172 cases. J Urol. 2000;164:364-6.
Miller S, McAninch JW. Penile fracture and soft tissue injury. In: McAninch JW, editor. Traumatic and Reconstructive Urology. Philadelphia: W.B. Saunders. 1996;693-8.
Mydlo JH. Surgeon experience with penile fracture. J Urol. 2001;166:526-8.
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;148:1171-80.