Cases Of Penile Fracture Research Articles

Case Report: Management of Penile Fracture with Urethral Injury in Two Patients

Penile fracture is a trauma accompanied by sudden pain, swelling, loss of erection, deviation, and ecchymosis along with a breaking sound in the penis. It can be accompanied by urethral injuries in 11-22% of patients, occurring due to force/blunt trauma to the erect penis. In this case report, we present two cases of penile fracture with accompanying urethral injury, occurring approximately one month apart. In our first case, surgical repair was performed approximately 1 hour after the incident, and in the second case, it was performed approximately 2 hours after the incident. Ultrasound (USG) was used as radiological imaging in both cases. In the second case, suspicion of urethral injury was mentioned in the USG. In both cases, a subcoronal circumferential incision was made, and the penile skin was degloved up to the radix. Damaged areas in the intraoperative tunica albuginea and urethra were observed in both cases. Postoperatively, the penile bandage of the first case was removed on the 4th day, and that of the second case was removed on the 6th day. The catheter was removed on the 20th day in both cases. In both cases, no loss of erection or penile deviation was observed at the 3-month postoperative follow-up. No clinical or uroflowmetric findings compatible with urethral stenosis were found in the 2nd and 3rd months post-op. The current approach to penile fractures is emergency surgical decompression and repair.

Fracture of the penis by Taghaandan's manoeuvre: About a case and literature review

Summary: The Taghaandan maneuver is a rare form of penile fracture. It is more observed in the Middle East and North Africa. We report a rare case of penile fracture occurring in a North African subject living in France, after the forced maneuver of lowering the penis to simulate erection, also called Taghaandan maneuver.

(132) Vertical Fracture of the Penis: A Rare Entity

Abstract Introduction Penile fracture is not an uncommon occurrence. It is a serious injury involving the rupture of the tunica albuginea in the erect state of the penis. While most cases are transverse fractures occurring during coitus, we present a rare case of a “vertical” penile fracture, the second reported in English literature. Objective To document a rare case of penile fracture i.e. a vertical penile fracture and its management. Methods A 33-year-old man presented to the emergency room of the hospital past midnight. He experienced sharp excruciating pain while attempting to penetrate vagina in a rear entry position. He gave a history of popping sound followed by detumescence, and increasing swelling of penis with discoloration and curvature. The pain continued though reduced in severity over time. The patient was evaluated under the guidance of consultant urologist (Author 2). Magnetic resonance imaging reported suspected vertical tear in tunica albugenia and also suspected urethral injury. Results Emergency surgery revealed a vertical long tunica albugenia tear along with corpora spongiosal tear and intact urethral mucosa. The tunica albugenia tear was primarily repaired. Good erectile function was reported by the patient, and normal sexual activity resumed after 6 weeks. Conclusions This case report emphasizes the need for clinicians to be aware of and consider this uncommon entity, “Vertical Tunica Albugenia tear” while managing penile fractures. The utilization of MRI imaging of the penis can provide valuable insights into the pattern and extent of the injury, aiding in appropriate management decision. Surgical intervention within 6–8 hours of the injury offers excellent result and preserves sexual function without complications. Disclosure No.

Management of Fractures of the Corpora Cavernosa at the University Clinic of Urology and Andrology at Cnhu-Hkm in Cotonou

Background: Penile fracture is a rare accident whose diagnosis relies on a stereotyped history and a physical examination. Early surgical intervention is recommended. In Africa, as well as in Benin, research on this pathology is limited due to likely underreporting, possibly linked to cultural factors. Objectives: This study aims to examine the epidemiological, clinical, therapeutic, and evolutionary aspects of penile fracture. Methods: It is a retrospective and descriptive study collecting records of patients treated and followed for penile fracture at the Urology Department of CNHU-HKM in Cotonou between January 2010 and March 2021. Results: Over the course of 10 years, 23 cases of penile fracture were identified, representing a frequency of 2.3 cases per year. The average age of patients was 35 years, with a predominance of married individuals (n=17). Coital misstep was the primary circumstance of occurrence (n=15). The cracking sound (n=14), pain (n=23), swelling of the penis (n=16), and detumescence (n=23) were the main clinical signs. The average time to medical intervention was 13 hours. Surgical treatment with a circumferential approach under the coronal ridge was employed for all patients. The average duration of hospitalization was 60 hours. The prevalence of erectile dysfunction was 8.7% (IIEF-5). Conclusion: Penile fracture is a rare traumatic emergency. Diagnosis is facilitated by a stereotyped clinical presentation. Early surgical intervention is the optimal treatment for a favorable functional outcome.

Penile fracture in burkina faso: our experience on the management of 21 cases

BackgroundPenile fracture is relatively a rare urological emergency and has been the topic of a few publications in the literature through clinical cases or case series. Despite this relative scarcity, it is increasingly reported as one of the andrological emergencies in Burkina Faso. The purpose of this study was to report our experience of the management of such andrological emergency in the two main university teaching hospitals of Burkina Faso.MethodsThis was a cross-sectional study, including retrospectively patients managed for a penile fracture between January 2016 and September 2021, and having a minimum postoperative follow-up of 6 months. The literature review was performed by analyzing the content of the following documents: consultation logs, patient records, operative report protocol. The parameters studied were age, mechanism of occurrence, clinical data, delay of management, operative technique and functional and morphological results after surgery. Erectile function was assessed by the IIEF5 score and rigidity by the EHS scale.ResultsAmong the 24 cases of penile fracture, 21 patients were included with a median age of 32.7 ± 5.74 years (23–43 years). The most common mechanism was a coital misstep or coitus interruptus (14 patients or 66.7%). Forced self-manipulation/masturbation was noted in 4 cases (19%), and direct trauma to the penis was noted in 3 cases (14.3%). Urethrorrhagia was reported by 5 patients. The mean delay of management was 65 h (6–432 h). The main sign found was the painful swelling of the penis with an “eggplant” appearance. The surgical approach was a circumferential balanopreputial incision in all our patients. Involvement of the spongy body and urethra associated with involvement of the cavernous body was noted in 4 patients, with a single case of spongy body and urethral involvement. The mean length of hospital stay was 3 days. Postoperatively, erectile dysfunction was noted in 6 patients. A palpable nodule at the penis was observed in 12 patients. No patient reported curvature of the penis.ConclusionPenile fracture is a clinical diagnosis requiring early exploration and surgical repair to ensure better functional and morphological outcomes.

Komplet üretra rüptürüyle birlikte olan penil fraktür

Penile fracture with complete urethral rupture OBJECTIVES: Penile fracture is a trauma that develops as a result of the rupture of the corpus cavernosum by forcing the erect penis to bend and twist and requires emergency surgery. Urethral trauma accompanies penile fracture in 1–40% of cases. In this study, we aimed to present a case of penile fracture with complete urethral rupture. CASE REPORT: A 51-year-old male patient presented to the emergency service with the complaints of sudden loss of erection, bruising and pain in the penile shaft after a cracking sound during coitus. Physical examination revealed limited ecchymosis and swelling in the penile shaft and hemorrhage in the external urethral meatus. Urethrography was performed on the patient due to urethrography. On urethrography, it was observed that there was contrast extravasation from the middle urethra. The patient was operated in the early period. In the midpenile region, it was observed that there were ruptures of approximately 1 cm in both corpus cavernosum and complete rupture in the urethra. Cavernosal ruptures and urethral rupture were repaired. At the postoperative 6th month follow-up, the patient had no erectile dysfunction and voiding symptoms. CONCLUSIONS: The “crackling sound” heard during coitus, severe pain and penile detumescence are typical clinical findings of penile fracture. If there are symptoms of bleeding in the meatus, hematuria and difficulty in voiding, urethral trauma should be considered. In these patients, urethral repair is also required during the operation. Keywords: penile fracture, urethral rupture, urethrorrhagia

Penile fracture with urethral rupture - case report

Introduction Penile fracture is a rupture of the tunica albuginea of the corpus cavernosum caused by an erect penis injury. It is noticed that hematomas always accompany penile fractures. We present a rare case of penile fracture between corpus cavernosus and urethra without hematoma formation. Case Presentation: A 41-year-old male patient presented to the emergency department due to a continuous flow of blood from his urethra, which started an hour earlier due to a penile injury during vigorous sexual intercourse. There was no audible 'snap' sound, but the incident was followed by severe pain and immediate loss of tumescence. His bleeding continued until surgery. No hematoma was observed – Figure 1. A urethrography was performed, and afterward, an experienced urologist inserted a catheter without encountering any resistance. The patient was diagnosed with rupturing the tunica albuginea of the corpus cavernosum and the urethra. No hematoma was found, and primary revision was performed. Urethra and tunica albuginea was sutured. After four weeks catheter was removed. The patient recovered with good uroflowmetry results and did not report erectile dysfunction. Conclusions Rapture of tunica albuginea to the urethra may cause severe bleeding without formation of the hematoma and "eggplant deformity." Therefore, early intervention is crucial to sustain erectile function and avoid urethral stricture.

Fracture Penis: Diagnosis, Treatment and Outcome of 9 Patients

Background: First reported case of penile fracture was made an Arab physician, more than 1000 years ago. Fracture penis not an uncommon genitourinary trauma, once it was thought. Sexual intercourse, masturbation, rolling over or falling onto the erect penis, abrupt blunt trauma by forceful bending of the erect penis etc. are the main causes of penile fracture. Treatment option of fracture penis now a days is operative. Materials and methods: It was a retrospective study. Patients with fracture penis admitted in the Department of Urology and Surgery Rangamati Medical College hospital and Chattogram National Hospital (Pvt.) Ltd. since May 2008 to December 2019 were included in this study. Total 9 patients were treated with fracture penis in this period of time. Patients were diagnosed by proper history, physical examination and investigations. Patients with genitourinary trauma due to other reasons were excluded from the study. Patient’s data were collected from hospital records and were analyzed later on. Results: Nine patients with fracture penis were included in this study. Six patients developed fracture during sexual intercourse, two during penile manipulation and one gave ambiguous history. After proper preoperative preparation and counselling, they underwent operation. The defect of tunica albuginea was identified and repaired. One patient had urethral injury which was also repaired at the time of repair of tunica albuginea. All the patients were evaluated post operatively. One patient had mild erectile dysfunction, others were normal. Conclusion: Immediate repair of the tunica albuginea was the corner stone of success. Bangladesh J. Urol. 2021; 24(1): 20-24

Consequences of penile fracture: Complications and long-term functional outcomes

IntroductionPenile fracture (PF) is a urological emergency with low incidence, and evidence of its long-term outcomes is scarce. This study focuses on postoperative complications and long-term functional outcomes in patients with PF and surgical repair at our center. Materials and MethodClinical records of patients undergoing urgent surgery for PF at a third level hospital between 2006 and 2020 were retrospectively reviewed. Functional outcomes were assessed with voluntary telephone interviews from June 2020 to February 2021. Lower urinary tract symptoms were screened by IPSS questionnaire, sexual function by EHS and IIEF-5 and morphological alterations by direct questions to patients. ResultsA total of 41 patients underwent surgery for PF. Eleven of them also had urethral injury (higher incidence if there was bilateral corpora cavernosa injury, 19.4% vs. 80%, p < 0.05). Only 1 patient presented a Clavien-Dindo type 3a complication due to wound dehiscence, 4 (13%) type 2 and 9 (29%) type 1. Twenty-four patients underwent long-term follow-up, of whom 20 (83.3%) presented normal sexual function. Twelve patients (50%) had a palpable nodule at the fracture site, 8 (33.3%) had new onset penile curvature and 1 patient with previous urethral injury presented urethral stricture. ConclusionIn cases of penile fracture, there is a higher incidence of urethral injury if both corpora cavernosa are affected. Long-term functional sequelae after surgical repair of a PF are rare.

Consecuencias de la fractura de pene: complicaciones y resultados funcionales a largo plazo

IntroductionPenile fracture (PF) is a urological emergency with low incidence, and evidence of its long-term outcomes is scarce. This study focuses on postoperative complications and long-term functional outcomes in patients with PF and surgical repair at our center. Materials and methodClinical records of patients undergoing urgent surgery for PF at a third level hospital between 2006 and 2020 were retrospectively reviewed. Functional outcomes were assessed with voluntary telephone interviews from June 2020 to February 2021. Lower urinary tract symptoms were screened by IPSS questionnaire, sexual function by EHS and IIEF-5, and morphological alterations by direct questions to patients. ResultsA total of 41 patients underwent surgery for PF. Eleven of them also had urethral injury (higher incidence if there was bilateral corpora cavernosa injury, 19.4 vs. 80%, P<.05). Only one patient presented a Clavien-Dindo type 3a complication due to wound dehiscence, 4 (13%) type 2 and 9 (29%) type 1. Twenty-four patients underwent long-term follow-up, of whom 20 (83.3%) presented normal sexual function. Twelve patients (50%) had a palpable nodule at the fracture site, 8 (33.3%) had new onset penile curvature and one patient with previous urethral injury presented urethral stricture. ConclusionIn cases of penile fracture, there is a higher incidence of urethral injury if both corpora cavernosa are affected. Long-term functional sequelae after surgical repair of a PF are rare.

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

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.

Penile Fracture—Report on Three Cases from Cape Coast, Ghana

Introduction: Penile fracture is a urological emergency that occurs when the penis in an erect state suffers a blunt trauma resulting in a rupture of the tunica albuginea of either one or both corpora cavernosa. It is often caused by vigorous sexual intercourse, hence the incidence of penile fracture is under-reported. We therefore present our experience of the clinical presentation and surgical management of penile fracture. Presentation of Cases: We report three cases of penile fracture and all were diagnosed based on their clinical presentation and examination findings. The patients include two middle aged men and one young man, all with history of hearing a popping sound and experiencing sudden onset pain with detumescence of the penis. No radiological investigations were carried out. An emergency surgical repair was done for all patients. Discussion: All the patients had no urethral injury on presentation and underwent immediate surgical repair. The erectile and voiding function of each patient was preserved. Conclusion: The management of penile fracture involves early diagnosis and immediate surgical repair. Early intervention is necessary to preserve penile function.

Two cases of penile fracture with and without associated urethral rupture: Case reports and review of the literature

Penile fracture is a rare lesion that occurs almost exclusively during erection. This lesion may be associated with rupture of the urethra in 20-30% of the cases. We present two cases of a 41-year-old man with a penile fracture complicated by a urethral rupture and a 33 year old man with a penile fracture without urethral rupture. Subsequent repair was done in both cases. For diagnosis it is necessary in most cases a correct anamnesis and physical examination. Early surgical approach and closure of the albuginea´s lesion and repair of the urethral lesion is the best way of treatment.

Penile fracture in a Peyronie\u2019s disease patient: a case report

BackgroundPenile curvature in men with Peyronie’s disease (PD)—caused by tunica anchoring plaques with loss of focal fiber elasticity—theoretically increases the risk of penile fracture during sexual activity. Penile fracture is the result of tearing of the tunica albuginea of one or both corpora cavernosa, usually during sexual intercourse, and is among the most serious urological emergencies. Generally, a patient presented to a surgical emergency within 48 h of injury can be handled successfully with minimum complications. Immediate surgical treatment is the current standard of care and has a relatively low risk of late complications.Case presentationWe present a case of penile fracture in a male with a history of PD referred to the emergency department with severe pain. Clinical history assessment and physical examination revealed a penile fracture with underlying PD. He underwent emergency surgical exploration via subcoronal incision. Penile plication was not necessary for our case because the angulation of the penis was less than 15° after examination of artificial erection.ConclusionPenile fracture in a patient with underlying PD is a rare urological emergency that should be treated surgically with fracture repair as early as possible. Penile plication might be necessary in severe cases (angulation > 60°).

Penile Fracture-Report of Two Cases and Review of Current Literatures

Penile fracture is an uncommon urological emergency especially in Bangladesh. The other name is traumatic rupture of the tunica albugenia and corpora cavernosa in erect penis. It occurs when an erect penis face to buckle under the pressure of a blunt sexual trauma. Patient gives the typical history of immediate detumescence, severe pain, swelling and eggplant deformity of the penile shaft due to penile injury. Immediate surgical exploration and repair of corpora Cavernosa with tunica albugenia is the most effective treatment modality. In normal cases diagnosis is made from history, physical examination alone. In some special cases ultrasonogram, radiological images, including retrograde urethrography or cavernosography are mandatory for proper diagnosis.Herein, we report 2 cases of penile fracture with review of current literature regarding treatment options. Bangladesh Journal of Urology, Vol. 19, No. 2, July 2016 p.98-102

Penile Fracture – Case Series

Fracture of the penis is a misnomer, the cause being rupture of one or both of the tunica albuginea that covers the corpora cavernosa. It usually occurs following sexual intercourse or masturbation. Here we report 2 cases of penile fracture in our institution. Ultrasonography was done which confirmed the diagnosis. In both the cases, the urethra was intact. Exploration with evacuation of the hematoma and repair of the tunica albuginea was done.

56] Penile fracture with urethral injury: Experience in a tertiary care hospital

ObjectiveTo present our experience in treating 12 cases of penile fracture with urethral injury. Penile fracture is a rare urological emergency that always requires immediate attention and it can be associated with urethral trauma in 9–20% of cases.

Isolated rupture of corpus spongiosum without urethral or cavernosal injury: A rare case of penile fracture

Isolated rupture of corpus spongiosum without urethral or cavernosal injury: A rare case of penile fracture

Notre experience de la prise en charge de la fracture de verge au CHU de Lomé

Objectivereport the management of a series of six cases of penile fracture in our hospital practice. Material and methodswe conducted a retrospective study of all cases of penis fracture identified in five years (October 2010-September 2015) at the University Hospital of Lome. The criteria considered were age, marital status, time of occurrence, the circumstances of occurrence, the occurrence mechanism, the delay of treatment, type of treatment and sexual function after treatment. The sexual function was assessed by the IIEF5 score during a telephone interview with each patient. Resultsin five years, six cases of penis fracture were recorded. The average age of patients was 37.3 years (25 years to 60 years). In two thirds of cases the fact of occurrence was a violent sexual intercourse, masturbation in a third. The average time of care was 74hours with a range of 12hours and 336hours. All patients were treated surgically. After a mean follow up of 18.5 months, 4 patients had normal erectile function and two patients reported erectile dysfunction (moderate disorders in one and middle disorders in the second). Discussionthe late management of patients in our conditions is imputable to the reluctance of African people to consult for disease concerning genital organs. The delay in treatment is a pejorative prognostic factor, but this small series does not allow us to draw definitive conclusions about the prognostic aspect. Our study is thus a preliminary work which is intended as a precursor to a wider study to come. ConclusionThe results of surgery of penile fracture in our experience are encouraging despite the narrowness of our series.

Fractured Penis: Not So Rare!

Introduction: Penile fracture is a relatively common phenomenon. The main problem associated with this condition is the lack of patients' awareness on the urgency of the situation. This study reports the different modes of presentations and treatment results. Materials and Methods: We reviewed 21 cases of penile fracture over 5 years. Parameters were mode of injury, age group, time interval before presentation, management, site of injury, urethral involvement, results, complications and erectile function at follow-up. Results: The mean age of patients was 34 years, the mean time interval until presentation was 26 h. Cases involving the right corpus cavernosum comprised 57.14% and 42.85% were cases involving the left corpus cavernosum. Two patients had full circumferential urethral tear. Two patients developed wound infections and 2 patients developed mild penile curvature (<30°). These 4 patients had all presented late for treatment (>40 h). Conclusion: Urologists need to consider penile fracture a urological emergency and atypical presentations need to be considered when deciding on management.