Surgical Outcome of Penile Fracture Management in a Tertiary Level Hospital in Bangladesh

Abstract

Background: Fracture of the penis is a urological emergency which occurs as a result of abrupt trauma to an erect penis. Immediate surgical repair is the standard of care and is superior to non- operative management due to excellent long term outcomes. Objective: The aim of this study was to investigate surgical and functional outcomes in patients who underwent penile fracture repair. Methods: A cross sectional descriptive study was conducted during the period of July 2017-June 2018 to find out the pattern of surgical management of fracture penis among the patients admitted in the urology department of Dhaka Medical College Hospital. A total 50 patients of fracture patients were selected purposively. Outcome of surgical management was investigated by using semi structured and International Index of erectile function questionnaire. Results: The study reveals that the mean age of the patients were 34.26±9.96 (range: 18–65), predominantly married (70%). The mean follow-up period was 12 weeks. Patients ‘history and clinical examination were highly sensitive and accurate in predicting a tunical tear. 15 patients (30%) received surgical treatment within six hours from the hospital admission, while 31 patients and 4 others seek surgical intervention within 6-24 hours and more than 24 hours respectively. It was revealed that the presenting symptoms were pain (72%), penile swelling (100%), eggplant deformity (100%), and hematuria (22%) with associated urethral injury in 22% of patients. Post- operative complications found were infection (14%), penile nodule (26%), chordee (14%), painful erection (16%) and erectile dysfunction (34%). There is a significant relationship between having painful erection and erectile function of the patients at the time of interview [X²=23.44, df=4, p=0.000], The relationship between the time elapsed from hospital admission to surgery and erectile function at the time of interview was not significant [X²=10.39, df=8, p=0.239]. The relationship ..