Abstract
A fracture of the penis is defined as the rupture of the tunica albuginea of corpora cavernosa as a result of blunt trauma to the erect penis commonly occurring during sexual intercourse or masturbation. Our objective is to present our experience in the management of penile fracture, surgical success and the complication rate. This study took place in the Urology Department of the Tripoli Medical Center on 26 patients in the form of a retrospective study between August 2003 and July 2018. The ages of the patients were between 19 and 61 years old (mean 34.23 years). The diagnosis was based on history and clinical examination. A circumferential sub coronal incision was made followed by degloving the penis to its base. The hematoma was evacuated and the tear was repaired using absorbable, interrupted stitches and the skin was closed with 3/0 undyed vicryl. Cefotriaxon 1 gm IV was given pre-operatively and continued for 5 days post-operative and diazepam 5 mg tab was given twice daily. The cause of penile fracture was masturbation in 11 patients. Intercourse was the cause in 9 cases and 6 were caused by rolling over the erect penis during sleep. All of the patients presented with swelling and ecchymosis and 18 patients underwent surgery within the first 24 hrs while 8 patients were operated on in the 2nd day. After six months of follow up, 19 patients (73.1%) were without complaint, of which 17 (89.47%) of them were operated on within the first 24 hrs and 2 patients (10.53%) were operated on in the 2nd day. Within the group, 7 patients (26.9%) had complications of which 6 patients were operated on after 24 hrs from the time of trauma and one patient who was operated on in the first 24 hrs and complained of painless penile deviation. Three patients had complications with penile deviation and with painful erection while 3 patients had complications of penile deviation. This experience showed that penile fracture is a rare urological emergency. Early surgical correction of penile fractures can be successful in preserving normal erections without significant complications whilst delayed operative management is associated with complications such as penile deviation and painful erection.
Highlights
Penile fracture is a relatively uncommon condition [1, 2] and is a rare Urological emergency. [3] The true incidence is unknown
[4] Fracture of the penis is defined as the rupture of the tunica albuginea of the corpora cavernosa, as a result of blunt trauma to the erect penis commonly occurring during sexual intercourse or masturbation. [1, 5] In the erect state the tunica thins from 2 mm to 0.25 mm and is more susceptible to traumatic tearing
International Journal of Clinical Urology 2019; 3(2): 36-39 clot over the tunical tear site which is pathognomic. [7, 10] In doubtful cases cavernosography, penile ultrasonography and even MRI have been used. [7, 11] Treatment remains controversial but immediate surgical exploration and repair is widely accepted as the therapy of choice in penile fracture and is superior to conservative treatment. [1, 8, 12]
Summary
Penile fracture is a relatively uncommon condition [1, 2] and is a rare Urological emergency. [3] The true incidence is unknown. Penile fracture is a relatively uncommon condition [1, 2] and is a rare Urological emergency. [3] The true incidence is unknown It has been reported as 1 of 175,000 hospital admissions, [3] and in a review of 183 publications, 1331 cases were reported between January 1935 and July 2001, mostly from the Mediterranean region. [4] Fracture of the penis is defined as the rupture of the tunica albuginea of the corpora cavernosa, as a result of blunt trauma to the erect penis commonly occurring during sexual intercourse or masturbation. Urethral injury with penile fracture is uncommon. International Journal of Clinical Urology 2019; 3(2): 36-39 clot over the tunical tear site which is pathognomic. [7, 10] In doubtful cases cavernosography, penile ultrasonography and even MRI have been used. [7, 11] Treatment remains controversial but immediate surgical exploration and repair is widely accepted as the therapy of choice in penile fracture and is superior to conservative treatment. [1, 8, 12]
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