Penile fracture: Tertiary care center experience and long-term complications after immediate repair.

Abstract

In the literature, there is not sufficient data on factors affecting the development of complications in patients with penile fracture after early surgical intervention. To investigate the predictors of long-term complications in patients who underwent immediate surgical repair for penile fracture. This clinical study included a total of 31 cases of penile fracture in which surgical treatment was performed within the first 24h and penile fracture was confirmed during the operation. The patients with and without late complications were compared in terms of parameters such as age, tear size of the tunica albuginea of the penis, bilateral involvement of the corpora cavernosa involvement, urethral injuries, and duration from penile fracture to surgery. The median age of the patients was 42 years (interquartile range: 34-51 years). The median time from penile fracture to surgery was 13h (8-18h). The median tear size was 16mm (11-21mm). Late complications were seen in 13 (41.9%) patients in the post-operative period. Erectile dysfunction developed in five (16.1%) patients in the post-operative period. There was no statistically significant relationship between age, tear size, time from penile fracture to surgery, and bilateral corporeal involvement in terms of erectile dysfunction development. Painful erections, penile deviations, urethral strictures, tunical scars, and re-fracture were the other late complications. There was a significant relationship between the development of any complication and time from penile fracture to surgery (p=0.028) and tear size (p=0.031). In the receiver operating characteristic analysis of complication development, the cut-off value for the time from penile fracture to surgery was 13.5h. We found that the longer time interval between penile fracture and surgery worsened the patient outcomes. In addition, tear size was determined to be a predictor for long-term complications. In our opinion, early treatment of penile fracture can prevent severe complications in these cases.