Abstract
Introduction: Penile fracture is a rare surgical emergency. It usually occurs as a single rupture of the tunica albuginea in one of the two corpora cavernosa; a rupture of both masses is an uncommon finding. We conducted this study to determine the etiology, clinical presentation and to review the causes and management of penile fracture. Methods: The retrospective study was carried out on 17 patients, admitted in the department of Urosurgery from January 2017 to December 2020 with penile fracture in a tertiary care teaching hospital in Kathmandu. Patient demographic profile, etiology, clinical presentation, time interval from injury to presentation, investigation done, treatment given and intraoperative findings were analyzed. Results: The main cause of penile fractures was sexual intercourse (82.35%) followed by manual manipulation (17.65%). Crackling sound (100%) followed by penile hematoma and pain were the most common presenting symptoms among the patients. Surgical exploration and repair of injury was done in all patients. Conclusion: Most of the time diagnosis of penile fracture can be made reliably by history and physical examination. Early surgical intervention is associated with a good outcome, regardless of the timing of presentation.
Highlights
Penile fracture is a rare surgical emergency
Surgical intervention is associated with a good outcome, regardless of the timing of presentation
Penile fracture was managed conservatively, but owing to its relatively high morbidity resulting in erectile dysfunction (ED), plaques, painful erections, curvature and infected hematomas ranging upto 30%, surgical exploration with repair of corpus cavernosa is considered a standard mode of management in recent days.[7,8,9]
Summary
Penile fracture is a rare surgical emergency. It usually occurs as a single rupture of the tunica albuginea in one of the two corpora cavernosa; a UXSWXUHRIERWKPDVVHVLVDQXQFRPPRQ¿QGLQJ:HFRQGXFWHGWKLVVWXG\ to determine the etiology, clinical presentation and to review the causes and management of penile fracture. $XWKRUDႈOLDWLRQVDepartment of Surgery, Nepal Army Institute of Health Science (NAIHS), Sanobharyang, Kathmandu, Nepal. Penile fracture is a rare surgical emergency. It usually occurs as a single rupture of the tunica albuginea in one of the two corpora cavernosa; a UXSWXUHRIERWKPDVVHVLVDQXQFRPPRQ¿QGLQJ:HFRQGXFWHGWKLVVWXG\ to determine the etiology, clinical presentation and to review the causes and management of penile fracture. Penile fracture is a rare presentation in Urosurgery with an incidence of 1 in 175,000.13HQLOHIUDFWXUHLVGH¿QHGDV the traumatic rupture of the tunica albuginea of the corpora cavernous.27KHPRVWFRPPRQFDXVHIRUSHQLOHIUDFWXUHLV sexual intercourse when the penis strikes the perineum or masturbation. Other causes include rolling over in bed on WRWKHHUHFWSHQLVIRUFHGÀH[LRQWRDFKLHYHGHWXPHVFHQFH and external blunt trauma.[3]. Penile fracture was managed conservatively, but owing to its relatively high morbidity resulting in erectile dysfunction (ED), plaques, painful erections, curvature and infected hematomas ranging upto 30%, surgical exploration with repair of corpus cavernosa is considered a standard mode of management in recent days.[7,8,9] Immediate surgical intervention has been associated with adequate functional and cosmetic results, with minimal complications.[10,11,12,13]
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