Sonourethrography With Pharmaco-Penile Doppler in Penile Fractures: A Complete and Productive Imaging Combination

2021 ◽  
Vol 37 (3) ◽  
pp. 305-310
Author(s):  
Arjit Agarwal ◽  
Manish Raj Singh ◽  
Pawan Joon
Keyword(s):  
Tunica Albuginea ◽  
Case Series ◽  
Late Complications ◽  
Penile Fracture ◽  
Efficient Manner ◽  
Current Case ◽  
Imaging Tool ◽  
Urological Emergency ◽  
High Resolution Ultrasonography

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.

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
Keyword(s):  
Surgical Treatment ◽  
Tunica Albuginea ◽  
Standard Of Care ◽  
Late Complications ◽  
Traumatic Rupture ◽  
Penile Curvature ◽  
Delayed Presentation ◽  
Current Standard ◽  
Penile Fracture ◽  
Urological Emergency

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.

scholarly journals Penile fracture in a 32-year old man with sexual dysfunction: A case report of rare outcome of the use of aphrodisiacs

2021 ◽  
Vol 14 (1) ◽  
pp. 071-074
Author(s):  
Paul O. Dienye ◽  
Japhet Nwapi ◽  
Alali Dan-Jumbo
Keyword(s):  
Sexual Dysfunction ◽  
Tunica Albuginea ◽  
Standard Of Care ◽  
Late Complications ◽  
Traumatic Rupture ◽  
Penile Curvature ◽  
Current Standard ◽  
Penile Fracture ◽  
Urological Emergency ◽  
Recreational Use

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.

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

KYAMC Journal ◽  
2019 ◽  
Vol 10 (2) ◽  
pp. 122-125
Author(s):  
Ashraf Uddin Mallik ◽  
Mostafizur Rahman ◽  
Fatema Bagum ◽  
Uttam Karmaker ◽  
Baikali Ferdous ◽  
...  
Keyword(s):  
Tunica Albuginea ◽  
Traumatic Rupture ◽  
Penile Fracture ◽  
Corpora Cavernosa ◽  
Effective Treatment Modality ◽  
Special Cases ◽  
History Of ◽  
Penile Injury ◽  
Urological Emergency ◽  
Erect Penis

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

scholarly journals Our experience with the management of penile fracture: a single institutional prospective observational study in eighteen patients over a two-year period

2021 ◽  
Vol 8 (7) ◽  
pp. 2089
Author(s):  
Soumish Sengupta ◽  
Supriya Basu ◽  
Kadambari Ghosh ◽  
Subhrajyoti Sengupta
Keyword(s):  
Observational Study ◽  
Sexual Intercourse ◽  
Erectile Function ◽  
Prospective Observational Study ◽  
Tunica Albuginea ◽  
Penile Curvature ◽  
Penile Fracture ◽  
Fracture Management ◽  
History Of ◽  
Urological Emergency

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.

scholarly journals FRAKTUR PENIS DENGAN RUPTUR CORPUS CAVERNOSUM DEXTRA TANPA DISRUPSI URETRA

2015 ◽  
Vol 37 (1) ◽  
pp. 70
Author(s):  
Rahmens Syamun ◽  
Dody Efmansyah ◽  
Alvarino Alvarino ◽  
Yevri Zulfiqar ◽  
Etriyel MYH
Keyword(s):  
Traffic Accident ◽  
Rare Case ◽  
Tunica Albuginea ◽  
Corpus Cavernosum ◽  
Blunt Injury ◽  
Primary Suture ◽  
Penile Shaft ◽  
Penile Fracture ◽  
Good Cosmetic ◽  
Urological Emergency

AbstrakFraktur penis merupakan kegawatdaruratan urologi yang jarang dan sebagian besarterjadi pada trauma tumpul pada penis yang mengalami ereksi. Fraktur penis sering terjadipada saat hubungan seksual dan jarang terjadi pada trauma tumpul karena benturan. Traumamenyebabkan robekan dan rembesan darah pada tunika albuginea. Intervensi bedah dapatmemberikan hasil penyembuhan yang baik secara fungsional dan kosmetik. Dilaporkankasus pada laki-laki usia 22 tahun yang datang dengan riwayat nyeri dan bengkak pada penissetelah benturan pada stang motor saat kecelakaan lalu lintas satu jam sebelum masuk rumahsakit. Pemeriksaan fisik didapatkan bengkak, hematoma pada batang penis, deformitasberupa angulasi ke kiri disertai nyeri tekan. Pasien masih bisa buang air kecil. Hasil urinalisisdidapatkan eritrosit 60-70/LPB, sedangkan darah rutin dalam batas normal. Kami memutuskanmelakukan eksplorasi, tampak rupture pada corpus cavernosum dan diperbaiki dengan jahitanprimer pada corpus cavernosum yang robek. Pasien dirawat selama 3 hari dan pulang denganfoley-catheter terpasang. Kasus pasien ini adalah salah satu contoh kasus dari fraktur peniskarena trauma tumpul penis secara langsung yang bukan disebabkan karena hubunganseksual.AbstractPenile fracture is a rare urological emergency that occurs almost exclusively due to blunttrauma on erect penis. Penile fracture often occurs during sexual intercourse and is rare in blunttrauma from impact. Trauma caused rupture and hematoma of tunica albuginea. Early surgicalintervention gives good cosmetic and functional outcome. We report the case of 22 -year-oldmale who presented to the emergency department 1 hour following blunt injury of his penisafter traffic accident. In physical examination we found swelling and haematom of penile shaft,angulation to the left and tenderness. Mixturation was normal. There were 60-70 eritrocytes inroutinely urinary examination. There were no abnormality in routinely blood examination. Weperformed an exploration and found rupture at corpus cavernosum. The rupture was repairedwith primary suture. The patient was hospitalized for 3 days and discharged with folley catheterinserted. This patient was an example of penile fracture caused by direct blunt trauma outsidesexual intercourse which is a rare case.

scholarly journals Surgical or conservative treatment of penile fracture

2008 ◽  
Vol 55 (1) ◽  
pp. 107-114 ◽  
Author(s):  
Dj. Nale ◽  
P. Nikic ◽  
I. Vukovic ◽  
D. Djordjevic
Keyword(s):  
Erectile Dysfunction ◽  
Conservative Treatment ◽  
Structural Integrity ◽  
Tunica Albuginea ◽  
Treatment Options ◽  
Late Complications ◽  
Penile Curvature ◽  
Penile Fracture ◽  
Penile Deviation ◽  
Duplex Doppler

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.

The Effect of PDE5 Inhibitors on the Male Reproductive Tract

2020 ◽  
Vol 26 ◽  
Author(s):  
Nikolaos Sofikitis ◽  
Aris Kaltsas ◽  
Fotios Dimitriadis ◽  
Jens Rassweiler ◽  
Nikolaos Grivas ◽  
...  
Keyword(s):  
Male Infertility ◽  
Reproductive Tract ◽  
Tunica Albuginea ◽  
Scientific Data ◽  
Secretory Function ◽  
Pde5 Inhibitors ◽  
Male Reproductive Tract ◽  
Review Study ◽  
Phosphodiesterase 5

The therapeutic range of cyclic nucleotide phosphodiesterase 5 inhibitors (PDE5) inhibitors is getting wider in the last years. This review study focuses on the potential employment of PDE5 inhibitors as an adjunct tool for the therapeutic management of male infertility. The literature tends to suggest a beneficial effect of PDE5 inhibitors on Leydig and Sertoli cells secretory function. It also appears that PDE5 inhibitors play a role in the regulation of the contractility of the testicular tunica albuginea and the epididymis. Moreover scientific data suggest that PDE5 inhibitors enhance the prostatic secretory function leading to an improvement in sperm motility. Other studies additionally demonstrate a role of PDE5 inhibitors in the regulation of sperm capacitation process. Placebo-controlled, randomized, blind studies are necessary to unambiguously incorporate PDE5 inhibitors as an adjunct tool for the pharmaceutical treatment of semen disorders and male infertility.

Pattern of Primary Vasculitis with Peripheral Ischemic Manifestations: Report of a Case Series and Role of Vascular Surgery

2015 ◽  
Vol 11 (999) ◽  
pp. 1-1
Author(s):  
Tamer A Gheita ◽  
Hisham M Abdel Samad ◽  
Maher A Mahdy ◽  
Alaa B Kamel
Keyword(s):  
Vascular Surgery ◽  
Case Series ◽  
Primary Vasculitis

scholarly journals Adenoidectomy for middle ear disease in cleft palate children: a systematic review

2021 ◽  
Author(s):  
Cecilia Rosso ◽  
Antonio Mario Bulfamante ◽  
Carlotta Pipolo ◽  
Emanuela Fuccillo ◽  
Alberto Maccari ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cleft Palate ◽  
Otitis Media ◽  
Middle Ear ◽  
Acute Otitis Media ◽  
Case Series ◽  
Velopharyngeal Insufficiency ◽  
Middle Ear Disease ◽  
Conductive Hearing

Abstract Purpose Cleft palate children have a higher incidence of otitis media with effusion, more frequent recurrent acute otitis media episodes, and worse conductive hearing losses than non-cleft children. Nevertheless, data on adenoidectomy for middle ear disease in this patient group are scarce, since many feared worsening of velopharyngeal insufficiency after the procedure. This review aims at collecting the available evidence on this subject, to frame possible further areas of research and interventions. Methods A PRISMA-compliant systematic review was performed. Multiple databases were searched with criteria designed to include all studies focusing on the role of adenoidectomy in treating middle ear disease in cleft palate children. After duplicate removal, abstract and full-text selection, and quality assessment, we reviewed eligible articles for clinical indications and outcomes. Results Among 321 unique citations, 3 studies published between 1964 and 1972 (2 case series and a retrospective cohort study) were deemed eligible, with 136 treated patients. The outcomes were positive in all three articles in terms of conductive hearing loss improvement, recurrent otitis media episodes reduction, and effusive otitis media resolution. Conclusion Despite promising results, research on adenoidectomy in treating middle ear disease in the cleft population has stopped in the mid-Seventies. No data are, therefore, available on the role of modern conservative adenoidectomy techniques (endoscopic and/or partial) in this context. Prospective studies are required to define the role of adenoidectomy in cleft children, most interestingly in specific subgroups such as patients requiring re-tympanostomy, given their known risk of otologic sequelae.

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