Penile Fracture:Presentation, Management and Erectile Function Following Surgical Repair

Abstract

Background: Penile fracture is a relatively uncommon condition that is defined as the rupture of the corpus carvernosum and or the corpus spongiosum caused by blunt trauma to the erect penis. Objective: To evaluate the clinical presentation, therapeutic options and outcome of the treatment of penile fracture. Materials and Methods: We evaluated the results of 11 patients of penile fracture. All patients underwent immediate exploration and primary repair of the tear in tunica albuginea. Degree of Erectile dysfunction was assessed by IIEF-5. Results: Eleven patients with median age of 35.1 years (range, 19-54 years) presented with fracture of the penis. Patient history and clinical examination were highly sensitive and accurate in predicting a tunical tear. The mode of injury was vigorous sexual intercourse in 4(36.4%) cases, self inflicted in 3(27.1%) cases, accidental trauma to erect penis in 3 (27.1%) cases and rolling over in bed in 1(9.1%) case. The median time from injury to presentation was 10 hours (range 4-360 hours). Associated urethral injury was seen in 2 (18.2%) cases. The mean hospital stay was 3 days. 7 (87.5%) out of 8 patients available for follow-up reported, achieving adequate erection for intercourse without erectile or voiding dysfunction. The patient who presented late at 15 days had significant erectile dysfunction. Conclusion: History and clinical examination are sufficient to diagnose fracture penis further evaluation is not necessary in most cases for managing patients with suspected penile fracture. Early surgical repair is associated with a good outcome with preservation of both sexual and voiding functions.