Penile fractures: the successful outcome of immediate surgical intervention (original) (raw)
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Penile fracture and investigation of early surgical repair effects on erectile dysfunction
Urologia Journal, 2019
Objectives: Penile fracture is one of the urological emergencies caused by direct trauma to an erect penis during sexual intercourse, which results in a tear in the tunica albuginea within the corpus cavernosum. Serious complications such as penile curvature and erectile dysfunction may develop due to inappropriate and/or late surgical repair. This study aims to evaluate patients with penile fracture and to describe their demographics, surgical repairs, and long-term outcomes. Materials and Methods: A total of 56 patients who were diagnosed with penile fracture between January 2012 and June 2017 were reviewed. Clinical features, pre-operative assessment, time from injury to surgery, tunica defect properties, and presence of urethral injury were assessed. Early surgical management was performed. Outcomes, including International Index of Erectile Function 5 pre-operation and after 6 months, were evaluated. Results: The mean age was 30.2 (18–57) years. In etiological questionnaires, 3...
Penile Fracture: Surgical Repair and Late Effects on Erectile Function
The Journal of Sexual Medicine, 2008
Introduction. Penile fracture is described as a traumatic rupture of the tunica albuginea because of blunt injury of an erect penis. Aim. To assess the etiology, treatment maneuvers, and late effects of penile fractures treated by surgical repair. Methods. Thirty-three patients diagnosed provisionally as having fractured penises. Thirty patients were managed by immediate surgical repair and three by delayed repair. Main Outcome Measures. International Index of Erectile Function-5 for married cases and Single-question Selfreport of Erectile Dysfunction questionnaires and recording complications after 2, 3, and 6 months. Results. The most common cause of fracture penis is self-inflicted acute bending (54.5%). The tear was visualized by ultrasound in 20/30 patients (66.7%) mostly on the right proximal third of the penis. All tears were unilateral with mean length 2.0 Ϯ 0.9 cm (range 0.5-4 cm). All patients who completed their follow-up after 6 months (N = 24) were able to achieve an adequate erection except two married cases who felt mild erectile dysfunction. Penile nodules were the most common postoperative complication (41.7%) after 6 months' follow-up. Patients treated with immediate or delayed repair had comparable complications. Conclusions. Fracture penis is not uncommon as an emergency that must be repaired either immediately or delayed. Clinical diagnosis is more predictive than ultrasound in diagnosis and determining the site of the tear. Ultrasound may be of value in patients where there is clinical doubt.
Surgical results in penile fracture: Our single center experience
The American Journal of Emergency Medicine, 2020
Penile fracture arises as a result of a unilateral or bilateral rupture of the tunica albuginea of the corpus cavernosum. It is a rare condition that requires urgent surgical intervention. In this study, we aimed to determine the effectiveness of surgical treatment in penile fracture and its effect on complications. Methods: The data of 21 patients who were admitted to the emergency department of our clinic between 2012 and 2019 and underwent emergency surgical repair with the diagnosis of penile fracture were collected retrospectively. The diagnosis of penile fracture was established by anamnesis and physical examination. Age, etiology, duration from trauma to surgery, physical examination findings,length and localization of the tunica albuginea defect, length of hospital stay, and postoperative first-, third-and sixth-month follow-up results were analyzed. Erectile function was evaluated using the International Index of Erectile Function (IIEF-5). Complications such as penile curvature, penile nodule and painful erection were evaluated. Results: The mean age of the patients was 36.8 ± 8.3 years. The most common reason of penile fracture was manually bending the penis for detumescence. All patients underwent surgery. The mean duration from trauma to surgery was 7.6 ± 3.1 h. The mean length of the tunica albuginea defect was 11 ± 2.5 mm. The mean length of hospital stay was 2.5 ± 0.5 days. The mean IIEF-5 scores in the postoperative first, third and sixth months were 20.5 ± 2.6, 22 ± 2.2, 22.1 ± 1.7, respectively. Conclusion: Penile fracture is a urological emergency, and timely surgery is an effective treatment method for preventing postoperative complications.
10-Year Multicentre Experience of Penile Fracture Repair Outcomes
Research Square (Research Square), 2023
Penile fractures are the traumatic rupture of the tunica albuginea encasing the corpora cavernosum. We reviewed long-term sexual and urinary outcomes following penile fracture repair. We performed a multicentre retrospective analysis with data from three metropolitan Australian hospital services over a 10-year period. Operative reports were reviewed and patients with intraoperatively con rmed fractures were included. Patients were contacted to complete a survey, composed of validated questionnaires including the International Index of Erectile Function-5 (IIEF-5) and International Prostate Symptom Score (IPSS). We analysed perioperative data against questionnaire responses. 55 patients were identi ed with penile fractures. 21 patients completed questionnaire follow-up. The median age was 44.8 years; the median time to follow-up was 4.0 years; 95.5% (20) of these cases occurred during sexual intercourse. The median IIEF-5 was 23 (no erectile dysfunction) and median IPSS was 5 (mildly symptomatic). Seven patients (33.3%) suffered bilateral cavernosal injury and eight (38.1%) suffered urethral injury. No signi cant relationships were found between injury factors and erectile or urinary function. We found promising outcomes for long-term erectile and urinary function. Study limitations include sample size and subjective outcome measurements. To completely de ne the relationship between injury factors and outcomes, larger cohorts will need to be analysed.
Diagnosis and Treatment of Penile Fractures: A Single Center Series
Open Journal of Urology, 2017
Objectives: The aim of this study is to review the diagnostic work-up, treatment methods and outcomes in patients treated for penile fractures. Methods: Thirty-one patients were treated for penile fracture during the period 2006-2014. Data were retrieved from patients' journals and analyzed retrospectively. Follow-up data were available for 23 patients. Results: Twenty-eight patients (90%) experienced immediate pain at incidence; 29 (94%) experienced immediate swelling; 23 (74%) heard a cracking sound; 20 (65%) observed a blue discoloration immediately afterwards and 20 (65%) got immediate detumescence. Magnetic Resonance Imaging was used preoperatively in 10 patients and demonstrated the side and localization of the rupture in tunica albuginea in all cases. A longitudinal incision over the suspected site of the rupture was used in 20 patients and a sub-coronal de-gloving incision of the penile skin was used in 10 patients. The average operation time with longitudinal incision method and de-gloving was 43 minutes and 57 minutes, respectively. Short term complications were seen in four patients and long term complications were seen in 14 patients of which deviation of penis during erection was most common. Conclusions: Immediate pain, swelling and hearing a cracking sound are predominant features in the history of patients with penile fracture. Magnetic Resonance Imaging is recommended for localizing the rupture site. A longitudinal incision over the rupture site means significantly shorter operation time than de-gloving.
Archivio Italiano di Urologia e Andrologia, 2014
Conclusions: The diagnosis is mainly clinical; however, radiological investigation is essential to confirm the diagnosis, assess the site and extent of the trauma and possible urethral involvement, so as to plan the most appropriate treatment. In addition, immediate treatment leads to better long-term results, with a lower incidence of ED and penile curvature. Psychologically, penile trauma intensifies the fear of reoccurrence; it decreases, however, with the passage of time.
Penile Fracture: Long-term Outcome of Immediate Surgical Intervention
Urology, 2010
To assess the etiology and the late effects of penile fractures treated by immediate surgical intervention. METHODS Between 1986 and 2008, a total of 155 patients with penile fracture were treated surgically in our center. The interval from injury to presentation was between 1 and 96 hours. Those patients were contacted by mail or phone and were re-evaluated. All patients were re-evaluated by questionnaire and local examination. Patients with erectile dysfunction were evaluated by color Doppler ultrasonography. RESULTS The most common cause of fracture of penis is sexual intercourse (51.5%). Unilateral and bilateral corporeal ruptures were present in 139 (89.7%) and 3 (1.9%) cases, respectively, whereas no tunical tear was found in 13 (8.4%) cases. Concomitant urethral injury was present in 14 (9%) cases. Long-term follow-up (Ͼ12 months) was available for 141 patients; among whom there was no complications in 108 (77%), painful erection in 2 (1.3%), penile deviation in 5 (3.2%), both in 1 (0.7%), erectile dysfunction in 11 (7.8%), and palpable scaring in 14 (10%). Scar formation was highly associated using nonabsorbable sutures (P Ͻ.001). CONCLUSIONS Vigorous sexual intercourse was found to be the most common cause of penile fracture. Immediate surgical intervention has low morbidity, short hospital stay, rapid functional recovery, and no serious long-term sequelae. Nonabsorbable sutures should be avoided as it has a higher incidence of scar formation. UROLOGY 75: 108-111, 2010.
Penile Fracture, Surgical Success and Complication Rate in 26 Cases
International journal of clinical urology, 2019
A fracture of the penis is defined as the rupture of the tunica albuginea of corpora cavernosa as a result of blunt trauma to the erect penis commonly occurring during sexual intercourse or masturbation. Our objective is to present our experience in the management of penile fracture, surgical success and the complication rate. This study took place in the Urology Department of the Tripoli Medical Center on 26 patients in the form of a retrospective study between August 2003 and July 2018. The ages of the patients were between 19 and 61 years old (mean 34.23 years). The diagnosis was based on history and clinical examination. A circumferential sub coronal incision was made followed by degloving the penis to its base. The hematoma was evacuated and the tear was repaired using absorbable, interrupted stitches and the skin was closed with 3/0 undyed vicryl. Cefotriaxon 1 gm IV was given pre-operatively and continued for 5 days post-operative and diazepam 5 mg tab was given twice daily. The cause of penile fracture was masturbation in 11 patients. Intercourse was the cause in 9 cases and 6 were caused by rolling over the erect penis during sleep. All of the patients presented with swelling and ecchymosis and 18 patients underwent surgery within the first 24 hrs while 8 patients were operated on in the 2nd day. After six months of follow up, 19 patients (73.1%) were without complaint, of which 17 (89.47%) of them were operated on within the first 24 hrs and 2 patients (10.53%) were operated on in the 2nd day. Within the group, 7 patients (26.9%) had complications of which 6 patients were operated on after 24 hrs from the time of trauma and one patient who was operated on in the first 24 hrs and complained of painless penile deviation. Three patients had complications with penile deviation and with painful erection while 3 patients had complications of penile deviation. This experience showed that penile fracture is a rare urological emergency. Early surgical correction of penile fractures can be successful in preserving normal erections without significant complications whilst delayed operative management is associated with complications such as penile deviation and painful erection.