Penile fracture: Management and long term results

Abstract

Penile fracture is an uncommon injury in the genitourinary organ which occurs following a blunt trauma to the erect penis during intercourse or masturbation, or after accidents. Penile fracture with urethral injury is even rare. The penis must be erect; the injury usually occurs when the partner is astride or when the penis is dislodged during the act of intercourse. Twenty-two patients with penile fracture were treated at our institution from November 1990 to March 2000. Patient ages ranged from 21 to57 years, with a mean age of 38.6±7.6 years. All of these injuries occurred during sexual intercourse or masturbation and received immediate surgical repair to avoid erectile dysfunction and penile curvature. Surgery consists of complete evacuation of hematoma and repair of the tunica albuginea. Only one patient with complete transection of the urethra received end-to-end anastomosis of the urethra and suprapubic urinary diversion was performed. Follow up period ranged from 6 months to 6 years. 18 patients (81.9%) had a normal erectile potency. Penile curvature occurred only in 3 patients (13.6%) and impotence in one patient (4.5%). Immediate surgical repair of tunica albuginea is recommended for preserving penile curvature.