Penile Fracture

Abstract

Penile fracture is defined as the rupture of the tunica albuginea of the corpus cavernosum caused by blunt trauma to the erect penis. The overwhelming majority of tunical tears are sexual in nature. There is significant geographical variation in the cause and incidence of penile fractures. Considered an uncommon injury by many, penile fracture rates may be increasing. The presenting features associated with true penile fractures are relatively consistent and typically straightforward. The simple clinical diagnosis usually renders adjunct imaging unnecessary, unless concomitant urethral injury is suspected. Historically, penile fracture management included mostly conservative, nonsurgical measures. In the 1980s, operative intervention became favorable after several studies demonstrated a decrease in long-term morbidity. The principles of penile fracture repair are dependable despite the many differing opinions about the timing of surgical exploration, the need for urethral catheterization, the type of incision and fashion of suture material utilized, and the requirement for prophylactic antibiotics. With adequate exposure and hematoma evacuation, the fracture site is identified and repaired. Most patients are discharged within 24 h with some men engaging in sexual activity 2 weeks after surgery. Today, urgent surgical exploration is the standard of care given fewer complications, shorter hospital stays, improved outcomes, and better patient satisfaction. Current observations note a rising trend of published reports in the world literature, despite low public awareness. Does the data reflect a greater world interest or an actual increase in traumatic penile ruptures? Regardless, penile fractures produce devastating physical, functional, and psychological consequences unless properly repaired.