Fracture of the penis in Jos, Nigeria: review of cases in 2020

Abstract

Background: Penile fracture is a urological emergency and requires urgent medical attention. There was a relative upsurge in 2020. Diagnosis is usually based on typical history and examination findings suggestive of penile fracture. The objective of this study was to determine the demographics, clinical presentation and management of fracture of the penis.Methods: All patients who presented at the accident and emergency in 2020 with penile fracture were studied. The patients age, time to presentation, mechanism of injury, clinical features (cracking sound, pain, immediate detumescence, penile swelling, urethral bleeding and acute urinary retention) were recorded. Intraoperative findings (location of corpora rupture, length of tear and urethral rupture) were recorded and analysed.Results: Twelve patients were studied. The mean age was 34.8 years, range (20 years to 56 years). 58.3% presented within 24 hours of trauma. The commonest mechanism of penile fracture was sexual intercourse with the woman on top position (58%). 75% of the patients heard a popping sound. All patients had pain, detumescence and penile swelling (N=12) 100%. Two patients had urethral bleeding (N=2) 16.7%, with one having associated urethral rupture (N=1) 8.3%. Two patients had acute urinary retention (16.7%). Rupture of the right corpora occurred in 50%, 8.3% had bilateral rupture of the corpora. All the patients had repair of the corporal rupture. Urethral injury was repaired primarily. Erection and voiding post-repair were satisfactory.Conclusions: Fracture of the penis is a urological emergency. Diagnosis can be made based on typical history and examination findings. Prompt surgical intervention is advised to avoid complications and erectile dysfunction.