Fracture of the Penis: About a Case of Delay in Management at the Nianankoro Fomba Hospital in Segou-Mali

Sory I Kone,M Keita,A Bah,M Togo,T B Bagayoko,A Fofana,T Traore,A Sanogo,A N Coulialy,D Coulibaly,B Samake,A Kassogue

doi:10.4236/oju.2022.122014

Abstract

Introduction: Fracture of the penis is a rare uro-andrological emergency defined as the rupture of the tunica albuginea of the erect penis most often during sexual intercourse. Surgical exploration and repair of the albuginea breach as soon as possible are the standard treatment. However, in our African context, early diagnosis and management are negatively influenced by the delay in consultation due to modesty. Our objective was to describe the clinical and therapeutic aspects of the fracture of the penis seen late in the African context and to compare it with the literature review. Presentation of the case: Our aim was to report our experience in the management of late-onset fracture of the penis, after more than 48 hours of evolution, by reporting the observation of a 54-year-old patient, who had a false coitus, treated in the urology department of the Nianankoro Fomba Hospital. The physical examination revealed a deformation of the penis following the formation of a large hematoma with a characteristic eggplant appearance. Therapeutically, a suture of the albuginea was performed with simple follow-up. Conclusion: This case study shows a delay in the management of this emergency due to the reluctance of the patient to be consulted as soon as possible for reasons of modesty. A delayed emergency surgical management was the only therapeutic alternative and the coronal incision with degloving was the only way to approach the voluminous hematoma related to the delay in management.

Highlights

Fracture of the penis is a rare uro-andrological emergency defined as the rupture of the tunica albuginea of the erect penis most often during sexual intercourse
Presentation of the case: Our aim was to report our experience in the management of late-onset fracture of the penis, after more than 48 hours of evolution, by reporting the observation of a 54-year-old patient, who had a false coitus, treated in the urology department of the Nianankoro Fomba Hospital
The physical examination revealed a deformation of the penis following the formation of a large hematoma with a characteristic eggplant appearance

Summary

Introduction

Fracture of the penis is a rare uro-andrological emergency defined as the rupture of the tunica albuginea of the erect penis most often during sexual intercourse. The diagnosis of a fracture of the penis is based on a typical clinical presentation associating a rapid detumescence of the penis, the formation of a hematoma, a cracking sound and a deformation of the penis. Surgical exploration and repair of the albuginea breach as soon as possible are the reference treatment with possibly an elective approach for trained operators in the case of a clearly localized fracture line. The coronal incision with degloving is the reference approach allowing a complete exploration with an associated lesion assessment despite the more important postoperative complications. The surgical treatment consists of evacuating the hematoma, performing hemostasis, trimming and suturing the tear of the albuginea. The management of a fracture of the penis must be done as a matter of urgency; in Mali, modesty has a negative impact on the arrival of certain patients in health facilities. Our objective was to describe the clinical and therapeutic aspects of the fracture of the penis in the African environment and to compare it with the literature review

Observation

Hospital Frequency

Etiology or Mechanism

Management

Conclusion