An Approach to management of penile fracture- Our Three-year experience at a Teaching Hospital
Penile fracture is a rare surgical emergency. It usually occurs as a single rupture of the tunica albuginea in one of the two corpora cavernosa; a rupture of both masses is an uncommon finding. We conducted this study to determine the etiology, clinical presentation and to review the causes and management of penile fracture.
The retrospective study was carried out on 17 patients, admitted in the department of Urosurgery from January 2017 to December 2020 with penile fracture in a tertiary care teaching hospital in Kathmandu. Patient demographic profile, etiology, clinical presentation, time interval from injury to presentation, investigation done, treatment given and intraoperative findings were analyzed.
The main cause of penile fractures was sexual intercourse (82.35%) followed by manual manipulation (17.65%). Crackling sound (100%) followed by penile hematoma and pain were the most common presenting symptoms among the patients. Surgical exploration and repair of injury was done in all patients.
Most of the time diagnosis of penile fracture can be made reliably by history and physical examination. Early surgical intervention is associated with a good outcome, regardless of the timing of presentation.
2.Ateyah A, Mostafa T, Nasser TA, Shaeer O, Hadi AA, Al-Gabbar MA. Penile fracture: surgical repair and late effects on erectile function. J Sex Med. 2008 Jun;5(6):1496–502.
3.Reis LO, Cartapatti M, Marmiroli R, de Oliveira Junior EJ, Saade RD, Fregonesi A. Mechanisms predisposing penile fracture and long-term outcomes on erectile and voiding functions. Adv Urol. 2014;2014 Apr;10(5):768-72.
4.Penbegul N, Bez Y, Atar M, Bozkurt Y, Sancaktutar AA, Soylemez H, et al. No evidence of depression, anxiety, and sexual dysfunction following penile fracture. Int J Impot Res. 2012 Jan;24(1):26-30.
5.Thompson RF. Rupture (fracture) of the penis. J Urol. 1954 Feb;71(2):226–9.
6.Ahmadnia H, Rostami MY, Kamalati A, Imani MM. Penile fracture and its treatment: is retrograde urethrograghy necessary for management of penile fracture? Chin J Traumatol. 2014 Dec;17(6):338–40.
7.Nason GJ, McGuire BB, Liddy S, Looney A, Lennon GM, Mulvin DW, et al. Sexual function outcomes following fracture of the penis. Can Urol Assoc J. 2013 Jul-Aug;7(7-8):252-7.
8.Swanson DE, Polackwich AS, Helfand BT, Masson P, Hwong J, Dugi DD, et al. Penile fracture: Outcomes of early surgical intervention. Urology. 2014 Nov;84(5):1117-21.
9.De Luca F, Garaffa G, Falcone M, Raheem A, Zacharakis E, Shabbir M, et al. Functional outcomes following immediate repair of penile fracture: A tertiary referral centre experience with 76 consecutive patients. Scand J Urol. 2017 Apr;51(2):170-5.
10.Kati B, Akin Y, Demir M, Boran OF, Gumus K, Ciftci H. Penile fracture and investigation of early surgical repair effects on erectile dysfunction. Urologia Journal. 2019 Nov;86(4):207-10.
11.Agarwal MM, Singh SK, Sharma DK, Ranjan P, Kumar S, Chandramohan V, et al. Fracture of the penis: A radiological or clinical diagnosis? A case series and literature review. Can J Urol. 2009 April;16(2):4568-75.
12.Jack GS, Garraway I, Reznichek R, Rajfer J. Current treatment options for penile fractures. Rev Urol. 2004 Jan;6(3):114-20.
13.Yamaçake KG, Tavares A, Padovani GP, Guglielmetti GB, Cury J, Srougi M. Long-term treatment outcomes between surgical correction and conservative management for penile fracture: Retrospective analysis. Korean J Urol. 2013 Jul;54(7):472-6.
14.Mirzazadeh M, Fallahkarkan M, Hosseini J. Penile fracture epidemiology, diagnosis and management in Iran: A narrative review. Transl Androl Urol. 2017 Apr;6(2):158-66.
15.Kowalczyk J, Athens A, Grimali A. Penile fracture: an unusual presentation with lacerations of bilateral corpora cavernosa and partial disruption of the urethra. Urology. 1994 Oct;44(4):599–601.
16.Fergany AF, Angermeier KW, Montague DK. Review of Cleveland Clinic experience with penile fracture. Urology. 1999 Aug;54(2):352–5.
17.Özorak A, Hoscan MB, Oksay T, Güzel A, Kosar A. Management and outcomes of penile fracture: 10 years’ experience from a tertiary care center. Int Urol Nephrol. 2014 Mar;46(3):519-22.
18.Shukla AK, Bhagavan BC, Sanjay SC, Krishnappa N, Sahadev R, V S. Role of ultrasonography in grading of penile fractures. J Clin Diagn Res. 2015 Apr;9(4):TC01-03.
19.Fetter TR, Gartmen E. Traumatic rupture of penis: Case report. Am J Surg. 1936 May;32(2):371-2.
20.Atat RE, Sfaxi M, Benslama MR, Amine D, Ayed M, Mouelli SB, et al. Fracture of the penis: management and long-term results of surgical treatment. Experience in 300 cases. J Trauma. 2008 Jan;64(1):121–5.
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright and Open Access Policy
This journal provides immediate open access to its content on the principle that making research freely available to the public supports a greater global exchange of knowledge.
JSSN applies the Creative Commons Attribution (CC BY) license to all works we publish. Under the CC BY license, authors retain ownership of the copyright for their article, but authors allow anyone to download, reuse, reprint, distribute, and/or copy articles in JSSN, so long as the original authors and source are cited. No permission is required from the authors or the publishers.
Article by JSSN is licensed under a Creative Commons Attribution 4.0 International License.
Based on a work at http://www.jssn.org.np/index.php?journal=jssn.