Surgical Treatment and Complications of Penile Fractures

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.

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Delayed Successful Surgical Repair of Penile Fracture: A Case Report

Current Urology ◽

10.1159/000489428 ◽

2018 ◽

Vol 12 (2) ◽

pp. 111-112 ◽

Cited By ~ 1

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.

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Fracture penis: rare occurrence

International Surgery Journal ◽

10.18203/2349-2902.isj20184656 ◽

2018 ◽

Vol 5 (11) ◽

pp. 3747

Author(s):

Akhilesh Kumar Yadav ◽

Sankalp Dwivedi ◽

Sagar Bassi ◽

Sunil Kumar Singh

Keyword(s):

Blunt Trauma ◽

Tunica Albuginea ◽

Corpus Cavernosum ◽

Penile Curvature ◽

Corpus Spongiosum ◽

Penile Fracture ◽

Immediate Surgery ◽

Almost All ◽

Erect Penis

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.

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Pulsative hematoma: A penile fracture complication

Vojnosanitetski pregled ◽

10.2298/vsp0701058d ◽

2007 ◽

Vol 64 (1) ◽

pp. 58-60

Author(s):

Djordje Nale ◽

Sava Micic

Keyword(s):

Case Report ◽

Surgical Treatment ◽

Blunt Trauma ◽

Sexual Intercourse ◽

Fracture Treatment ◽

Early Complication ◽

Penile Fracture ◽

Fracture Complication ◽

Erect Penis

Background. Fracture of the penis is a direct blunt trauma of the erect or semi-erect penis. It can be treated by conservative or surgical means. Retrospective analyses of conservative penile fracture treatment reveal frequent immediate and later complications. Case report. We presented a 41- year-old patient with pulsative hematoma caused by an unusual fracture of the penis. Fracture had appeared 40 days before the admittance during a sexual intercourse. The patient was treated surgically. Conclusion. Pulsative hematoma (pulsative diverticulum) is a very rare, early complication of a conservatively treated penile fracture. Surgical treatment has an advantage over surgical one, which was confirmed by our case report.

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

International Surgery Journal ◽

10.18203/2349-2902.isj20212712 ◽

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.

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Penile Fracture: Simultaneous Complete Urethral Rupture with Bilateral Corpora Cavernosa Rupture

Case Reports in Urology ◽

10.1155/2018/4929518 ◽

2018 ◽

Vol 2018 ◽

pp. 1-3 ◽

Cited By ~ 1

Author(s):

Ibrahim Alnadhari ◽

Osama Abdelhaleem Abdeljaleel ◽

Venkata Ramana Pai Sampige ◽

Ausama Abdulmuhsin ◽

Ahmad Shamsodini

Keyword(s):

Blunt Trauma ◽

Sexual Intercourse ◽

Rare Case ◽

Urethral Injury ◽

Penile Fracture ◽

Surgical Exploration ◽

Corpora Cavernosa ◽

Retrograde Urethrogram ◽

Proximal Urethra ◽

Urethral Rupture

Penile fracture is not uncommon blunt trauma to the penis. Here, we present a rare case of penile fracture during sexual intercourse. The patient presented with penile swelling, bleeding per urethra, and inability to pass urine. Retrograde urethrogram showed significant extravasation of contrast from anterior penile urethra and no contrast passing to proximal urethra. Surgical exploration showed complete urethral rupture and bilateral cavernosal rupture. This case represents the value of urethrogram to evaluate the urethral injury and the association of complete urethral injury with bilateral ventral cavernosal injury.

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Penile fracture: Retrospective analysis of our case history with long-term assessment of the erectile and sexological outcome

Archivio Italiano di Urologia e Andrologia ◽

10.4081/aiua.2014.4.359 ◽

2014 ◽

Vol 86 (4) ◽

pp. 359 ◽

Cited By ~ 17

Author(s):

Nicola Pavan ◽

Giorgia Tezzot ◽

Giovanni Liguori ◽

Renata Napoli ◽

Paolo Umari ◽

...

Keyword(s):

Erectile Function ◽

Psychological Impact ◽

Point Of View ◽

Long Term Results ◽

Penile Curvature ◽

Penile Fracture ◽

Radiological Investigation ◽

Urinary Disorders ◽

Patient Reported

Objectives: To review the cases of patients with suspected penile fracture and asses erectile and sexological outcomes. Materials and methods: from 1987 to 2013 presented to the Urology Clinic of Trieste and at the AIED of Pordenone a total of 41 cases that were divided into two groups according to the timing of treatment: 18 patients with anamnestic diagnosis of penile fracture treated nonimmediately and 23 patients treated immediately after the trauma. For all patients we evaluated the type of treatment adopted, the occurrence of complications and reoperations and the follow-up. The erectile function was also evaluated through the IIEF, as well as the psychological impact of the trauma on social and sex life, using a psycho- sexological questionnaire. Results: Among patients treated immediately after the trauma 14 were subjected to surgery. About a year after surgery, penile curvature was reported in 1 patient, pain in 3 patients, urinary disorders in 1 patient, while none reported erectile dysfunction (ED). Out of these, only 3 patients underwent reoperation. Among those treated conservatively 1 patient reported curvature, 1 patient reported pain and none reported ED. Among patients who were admitted at a later date, 14 reported curvature and 4 reported pain whereas urinary disorders were reported in 1 and ED in 4 patients. From a psychological point of view, the trauma caused in most cases a fear of new trauma and of repercussions on erectile function and sensitivity. 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.

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Urinary and sexual functions after surgical treatment of penile fracture concomitant with complete urethral disruption

Archivio Italiano di Urologia e Andrologia ◽

10.4081/aiua.2014.1.15 ◽

2014 ◽

Vol 86 (1) ◽

pp. 15 ◽

Cited By ~ 5

Author(s):

Ali Abdel Raheem ◽

Hassan El-Tatawy ◽

Ahmed Eissa ◽

Abdel Hamid Elbahnasy ◽

Mohamed Elbendary

Keyword(s):

Case Series ◽

Surgical Reconstruction ◽

Urethral Injury ◽

Penile Curvature ◽

Retrospective Case ◽

Penile Fracture ◽

Case Series Study ◽

Long Term Follow Up

Objectives: Penile fracture with concomitant complete urethral disruption is an uncommon urologic disorder. Data about the treatment and outcome measurements of this condition are scarce in the literature. The aim of the present study is to evaluate the long term urinary and sexual functions of patients with penile fracture associated with complete urethral injury after immediate surgical reconstruction. Patients and methods: Twelve patients met our inclusion criteria and were included in this retrospective case series study; however, one was lost during follow-up. Patient's medical records were reviewed and all patients were interviewed for clinical evaluation. Urinary function was assessed by history, uroflometry and retrograde urethrography, while, sexual function was assessed by questionnaire (Sexual Health Inventory for Men) and penile Doppler for patients with erectile dysfunction. Results: Patients’ mean age was 32.3 ± 7.5 years (range 21-43) and the mean follow-up period was 72.6 ± 45.4 months (range 14-187). Vigorous sexual intercourse was the main cause in 91% of our patients. No serious long term complications was found. Only 1 patient (9%) suffered from anterior urethral stricture, 1 patient (9%) complained of weak erection, 3 patients (27%) had a palpable fibrosis and 2 patients (18%) reported a slight penile curvature during erection. Ninety one percent of all our patients maintained their normal urinary and sexual functions. Conclusion: On the long term follow-up, most of the patients maintained their normal erectile and voiding functions with no harmful long-term complications. We advocate immediate surgical intervention and reconstruction of both corpora cavernous and urethra as a first line treatment for those patients.

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Surgical Correction of Penoscrotal Web: A Case Series With Literature Review

The Journal of Tepecik Education and Research Hospital ◽

10.5222/terh.2020.62134 ◽

2020 ◽

Author(s):

Volkan Sarper Erikçi

Keyword(s):

Surgical Treatment ◽

Clinical Characteristics ◽

Surgical Techniques ◽

Case Series ◽

Scrotal Skin ◽

Penile Skin ◽

Surgical Experience ◽

Postoperative Results ◽

Pediatric Urologist

INTRODUCTION: Penoscrotal webbing (PSW) is an anomaly of penis and it includes penile and scrotal skin aberration. There are various surgical techniques for repairing PSW with different terminologies. Herein we present our surgical experience of Z-plasty procedure in these cases. METHODS: In this retrospective study, 5 patients with an average age of 46 months who were diagnosed and under follow-up for PSW, between June 2017 and May 2019 were included. Along with demographic and clinical characteristics, treatment and follow-up records were collected. RESULTS: Isolated PSW was observed in 4 patients and one patient had an associated megameatus intact prepuce (MMIP) of a hypospadias variant in addition to PSW. Circumcision and ventral prepuce reconstruction of the penis with the aid of "Z-plasty" solved problem and acceptable postoperative results were obtained. DISCUSSION AND CONCLUSION: PSW is a condition that warrants surgical treatment. During the management of these children, in the case of suspicion of penile skin abnormality at the time of circumcision, it should be deferred and should be consulted to a pediatric surgeon or a pediatric urologist. Gentle surgical treatment is recommended for a favourable surgical and psychological result

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