scholarly journals Delayed Successful Surgical Repair of Penile Fracture: A Case Report

2018 ◽  
Vol 12 (2) ◽  
pp. 111-112 ◽  
Author(s):  
Ioannis Galanakis ◽  
Konstantinos Adamos ◽  
Evangelos Spyropoulos ◽  
Stamatios Mavrikos

Penile fracture is a very rare urological emergency resulting from traumatic rupture of the tunica albuginea of one or both corpora cavernosa, usually during sexual intercourse. Immediate surgical treatment is the current standard of care with lower risks of late complications, including erectile dysfunction, penile curvature, and tunical scar formation. We, hereby, report an over delayed presentation (23 days) of a penile fracture, which was successfully managed surgically. Our case emphasizes on the fact that there are not any “lost” cases and surgical treatment should always be offered to penile fracture, independently of delayed presentation.

2021 ◽  
Vol 14 (1) ◽  
pp. 071-074
Author(s):  
Paul O. Dienye ◽  
Japhet Nwapi ◽  
Alali Dan-Jumbo

Penile fracture is a very rare urological emergency resulting from the traumatic rupture of the tunica albuginea of one or both corpora cavernosa. Immediate surgical treatment is the current standard of care with lower risks of late complications, including erectile dysfunction, penile curvature, and tunical scar formation. We report a case of a patient with sexual dysfunction who took a combination of Anafranil and Sildenafil to enhance his sexual performance to satisfy his girlfriend, but ended with a penile fracture. Our case exposes the degree of frustration suffered by patients with sexual dysfunction and the extent to which they can go in the quest for a solution to their problem, the outcome may be unfavorable.Patients should be informed about the possible complications of Sildenafil either used singly or co-administered with Anafranil for improved sexual function, and recreational use of these drugs should be discouraged.


KYAMC Journal ◽  
2019 ◽  
Vol 10 (2) ◽  
pp. 122-125
Author(s):  
Ashraf Uddin Mallik ◽  
Mostafizur Rahman ◽  
Fatema Bagum ◽  
Uttam Karmaker ◽  
Baikali Ferdous ◽  
...  

Penile fracture is an uncommon urological emergency, especially in Bangladesh. The other name is traumatic rupture of the tunica albuginea and corpora cavernosa in the 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. KYAMC Journal Vol. 10, No.-2, July 2019, Page 122-125


2020 ◽  
Vol 26 (1) ◽  
Author(s):  
Nur Hidayatullah ◽  
Khoirul Kholis ◽  
Muhammad Asykar Palinrungi ◽  
Syakri Syahrir ◽  
Syarif Syarif ◽  
...  

Abstract Background Penile 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 presentation We 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. Conclusion Penile 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°).


2021 ◽  
Vol 8 (7) ◽  
pp. 2089
Author(s):  
Soumish Sengupta ◽  
Supriya Basu ◽  
Kadambari Ghosh ◽  
Subhrajyoti Sengupta

Background: Penile fracture is a not an unusual encounter in urological emergency. The condition results from disruption of the tunica albuginea which envelops the corpora cavernosa as a result of any condition which leads to the sudden rise of intra-cavernosal pressure. The study was designed to analyse the clinical spectrum and complication of penile fracture.Methods: This is a prospective observational study undertaken from April, 2019 to March, 2021on 18 patients. The demographic profile of all the patients, aetiology of penile fracture, management strategies and pre-operative sexual functions were documented. Erectile function was evaluated using international index of erectile function (IIEF).Results: Seventeen out of 18 patients (94.44%) gave a history of injury during sexual intercourse. Out of the seventeen patients with history of injury following sexual intercourse, only 9 (52.94%) were married. 15 (93.75%) had disruption of the tunica albuginea in the ventrolateral position with 10 patients (66.66%) on the right side. Patients were followed up in the OPD after 2 weeks and then at 6 month and 1-year intervals. At 12 months postop, none of the patients complained of sexual inactivity. Average time to return to sexual activity was 3.2 months. Two patients complained of penile curvature >20 degree. Six patients complained of penile nodule at the site of repair.Conclusions: Penile fracture is a urological emergency which is primarily diagnosed clinically. Prompt diagnosis and surgical exploration gives good outcome in terms of preservation of sexual function.


2008 ◽  
Vol 55 (1) ◽  
pp. 107-114 ◽  
Author(s):  
Dj. Nale ◽  
P. Nikic ◽  
I. Vukovic ◽  
D. Djordjevic

Introduction: Penile fracture presents with rupture of corpora cavernosa. It is not rare but is remarkable. Treatment options are controversial. Aim: To establish the incidence, what are early and late complications in patients treated surgically or with conservative treatment options (prospective/retrospective and randomized analysis). To find out what therapy verified as superior. Material and method: The total of 32 patients with typical acute penile fracture were analyzed. The patients were between 20 and 56 years of age (Mean age 40+7.25 SD). A total of 11 patients that presented up to 48h after the rupture of tunica albuginea (34.37%) were operated, while 9 patients (28.13%) were conservatively treated. 12 patients (37.5%) reported to andrology consulting room due to penile fibrous alterations and/or erectile dysfunction 6 to 14 months after the anamnesticaly established, typical penile fracture ("primary latent penile fracture"). Both groups of patients were strictly clinically followed 3, 6, 9 and 12 months after the penile fracture. Eventual development of late complications (erectile dysfunction ED, penile curvature, induratio, caverno-urethral fistula and urethral stenosis) was also recorded. Etiology of ED was investigated: anamnesticaly, by hormone and laboratory analysis, using penodynamic test (PGE1), Duplex Doppler echosonography, and dynamic cavernosography. Results: In the operated group of patients, (11 pts, 34.37%) preserved erectile capacity was recorded and no penile deformity or plaque lesions on the site of suture, after the patients were recommended to have 4 weeks of sexual abstinence. The rupture of tunica albuginea was always transversal in relation to penile axis i.e. in relation to axial force against which the penis acts during the intercourse. The rupture is always on the basis or mid penile portion . Out of 21 (65.63%) conservatively treated patients in 13 (61.9%) plaque lesions (longitudinal diameter 2 cm) was recorded, while sexual dysfunction was established in 13 patients (12 with ED and 1 patient with incapability for vaginal penetration). Evaluation of post therapeutical complications in relation to type of treatment, significantly higher frequency was recorded in the group of conservatively treated patients (p<0.01). Penile veno-oclusive dysfunction was registrated as significantly most frequent cause of ED (in 10 - 76.92% out of 13 patients). All patients with ED had palpable fibrous lesion similar to Peyrone?s plaque, while the degree of penile deviation correlated to the size of plaque lesion. Conclusion: The late complications of penile fracture were significantly more frequently recorded in the group of conservative treated patients (p< 0.01) which proves that this lesion presents as urgent urological entity. The penile rupture is always transversal, and most probable place of rupture is physiological penile curve since this is the site of weakened structural integrity.


2021 ◽  
Vol 37 (3) ◽  
pp. 305-310
Author(s):  
Arjit Agarwal ◽  
Manish Raj Singh ◽  
Pawan Joon

Penile fracture is a rare urological emergency requiring prompt diagnosis and management. The role of high-resolution ultrasonography is established in detecting a tear, in the tunica albuginea. The late complications of penile fracture are distressing and may manifest as asymmetrical and insufficient penile tumescence, penile ischemia, and sometimes urethral stenosis. The current case series demonstrates the combined role of post-papaverine penile Doppler duplex ultrasonography and sonourethrography techniques in assessing the late presenting cases of penile fractures. The combination of these two techniques was found to be a useful comprehensive imaging tool. This combination can be employed in clinical practice to define the extent of trauma and penile insufficiency, in an efficient manner.


2020 ◽  
Vol 19 (2) ◽  
pp. 98-102
Author(s):  
Ashraf Uddin Mallik ◽  
MD Tareque Hasan ◽  
Horobilash Halder

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


2007 ◽  
Vol 7 (1) ◽  
pp. 37-39 ◽  
Author(s):  
Benjamin Kulovac ◽  
Damir Aganović ◽  
Dželaludin Junuzović ◽  
Alden Prcić ◽  
Osman Hadžiosmanović ◽  
...  

Paper goal is to determine complications after urgent surgical treatment of patient with penile fractures, by using circumferential-degloving technique (degloving penile skin to root of penis). In period between 1998-2006 year, 23 patients have been treated as urgent cases with clinically proven penis fracture, age between 18 and 35. Patients were treated in 3 medical centers in Bosnia and Herzegovina(Sarajevo, Tuzla and Zenica). All 23 (100%) patients were injured during sexual intercourse. In the case of 20 (86,9%) patients partial rupture of corpus cavernosum was verified. Two (8,6%) patients had a complete rupture of urethra and it was primary sutured. In 22 cases (95,6%) spontaneous erection appeared, and in the case of 2 (8,6%) patients penile curvature was verified. Urgent surgical treatment is the best therapy choice, which enables preservation of erection in great number of cases in patients with penile fracture.


2018 ◽  
Vol 5 (11) ◽  
pp. 3747
Author(s):  
Akhilesh Kumar Yadav ◽  
Sankalp Dwivedi ◽  
Sagar Bassi ◽  
Sunil Kumar Singh

Fracture Penis is not usual. It is a tear in the tunica albuginea of the corpora cavernosa with or without involvement of corpus spongiosum and urethra. The usual cause is abrupt bending of the erect penis by blunt trauma, most commonly during sexual intercourse. A crackling sound, pain, detumescences, bruising, swelling, and bleeding per urethra are the common symptoms reported by the patients. Early surgical management is treatment of choice. Diagnosis of Penile Fracture refers to a rupture of the corpus cavernosum induced by blunt trauma to erect penis. Mainly diagnosed clinically from their stereotypical crackling sound from the erect penis at the moment of injury, rapidly followed by acute swelling, pain and penile deformity. Treatment recommendations include immediate exploration and repair. Surgical repair requires evacuation of hematoma, identification of tear, repair of the tear and ligation of any disrupted vasculature. Long term complications after repair include penile deviation, painful intercourse, painful erection and erectile dysfunction. The diagnosis of penile fracture is mostly clinical. Based on physical examination and typical crackling sound at the time of injury. Prompt surgical exploration and repair are advocated in almost all cases. Immediate surgery reduces long term complication which is post-traumatic penile curvature.


2021 ◽  
Vol 4 (1) ◽  
pp. 56-58
Author(s):  
Ashok Kumar Yadav ◽  
Sudhir Kumar Singh ◽  
Raju Chapagain ◽  
Prem Das ◽  
Jag Mohan Osti ◽  
...  

Penile fracture is a urological emergency caused by blunt trauma to an erect penis. We report a case of a 40-year-old male who presented with a complaint of a painful swelling of the penis for 4 days. On examination, a flaccid swollen tender penis with bluish discoloration over the shaft and scrotum was noted. A clinical diagnosis of delayed penile fracture was made which was managed immediately surgically under spinal anesthesia. Ourreport emphasizes that penile fracture is diagnosed solely on a reliable history and clinical examination. It has outstanding outcome despite delayed presentation if treated promptly.


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