​​The Effect of Platelet Rich Plasma on Wound Healing in the Repair of Experimental Penile Fractures

2021 ◽  
Author(s):  
E. Duz ◽  
B. Beger ◽  
K. Saglam ◽  
E. Duz ◽  
S. Yildirim
Keyword(s):  
Clinical Manifestation ◽  
Platelet Rich Plasma ◽  
Primary Repair ◽  
Tunica Albuginea ◽  
Corpus Cavernosum ◽  
Control Group ◽  
Penile Fracture ◽  
Histopathological Findings ◽  
Conservative Group ◽  
Fracture Area

Background: Penile fractures are caused by the rupture of the tunica albuginea and the underlying layers of corpus cavernosum as a result of the exposure of the erect penis to blunt trauma. Although conservative treatment methods have been recommended in former studies, recent studies favor early surgical options. Platelet-rich plasma (PRP) is a blood product rich in cytokines and several growth factors, obtained from the patient’s own blood commonly used to stimulate healing in acute and chronic wound treatments. The efficiency of homologous PRP treatment in rats with penile fractures have been assessed in terms of clinical manifestation and histopathological findings in the present study. Methods: Thirty-five rats were randomly divided into five groups, each containing seven rats as follows: 1. Conservative group: Following the formation of penile fracture, medical interventions were not initiated on fracture area and the wound was left for secondary healing. 2. Bandage group: Following the formation of penile fracture, self-adherent elastic bandage (3M Coban) was applied to the fracture area for three days. 3. Primary repair group: Following the formation of a penile fracture, the lacerated area was repaired with 7/0 vicryl primary sutures. 4. Primary repair + Homologous Platelet Rich Plasma group: Before the operation, 10 cc of blood was taken from one rat under general anesthesia by intracardiac puncture and PRP material was prepared from this blood. Homologous PRP was topically administered on the wound in the fracture area and then the penile fracture was repaired with 7/0 vicryl as simple separate stitches. 5. Non-operative control group: Surgical procedures were not applied to this group; it was used as the control group. Result: The effect of the PRP treatments on the surgical repair options in the rats with penile fractures was investigated. The present findings revealed that following the repair with conservative treatments, the fracture format persisted and various complications like infection, oedema, excessive fibrosis and hyperemia were encountered. On the other hand, the best healing was achieved in primary repair + PRP group in terms of clinical manifestation and histopathological findings.

scholarly journals Non sex-related subtotal rupture of the corpus cavernosum without urethral injury: A case report and literature review

2016 ◽  
Vol 88 (3) ◽  
pp. 233 ◽  
Author(s):  
Zeki Bayraktar ◽  
Selami Albayrak
Keyword(s):  
Surgical Repair ◽  
Tunica Albuginea ◽  
Correct Diagnosis ◽  
Corpus Cavernosum ◽  
Early Surgery ◽  
Urethral Injury ◽  
Penile Fracture ◽  
Minimal Rate ◽  
The Right

Although penile fracture is a rare case, it is a well-described urologic emergency. It results from the rupture of the tunica albuginea of corpora cavernosa by blunt strain that commonly mandates immediate surgical exploration. Urethral injury may also accompany penile fracture. An ideal anamnesis and a special physical examination were determinant to achieve a correct diagnosis. It is usually diagnosed based on clinical examination, but ultrasonography can be very helpful in diagnosis. The treatment is based on the presence of associated urethral injury. Early surgery is preferable to conservative management, because it is associated with better outcomes and fewer long-term complications. The surgical repair of cavernous body can produce good results, with a favorable prognosis and minimal rate of complications. We present a penile fracture case of 34-year-old with subtotal rupture of the right corpus cavernosum without urethral injury who treated by early surgery and good results.

scholarly journals Histopathological effects of fibrin glue on penile fracture in a rat model

2011 ◽  
Vol 34 (6) ◽  
pp. 336 ◽  
Author(s):  
Cemal Tasdemir ◽  
Emine T Samdanci ◽  
Muhammet G Turtay ◽  
Cemal Firat ◽  
Hakan Oguzturk ◽  
...  
Keyword(s):  
Fibrin Glue ◽  
Primary Repair ◽  
Dorsal Side ◽  
Control Group ◽  
Albino Rats ◽  
Penile Fracture ◽  
Tissue Healing ◽  
Significant Difference ◽  
Cavernous Tissue ◽  
Histopathological Effects

Purpose: To evaluate both histopathological effects and potential clinical application of fibrin glue on the penile cavernosal tissue. Methods: Experimental penile fracture was formed by incising from the proximal dorsal side of the penis in 32 Wistar Albino rats. The rats were randomly assigned to four main groups of eight animals each. In the control group, the incision was not repaired and it was left to secondary healing. In the primary repair group, the incision was primarily repaired. In the fibrin glue group, glue was applied only to the incision. In the final group, fibrin glue was applied to the incision following primary repair. Three weeks later, penectomy tissue was examined histopathologically. Results: When the control group was compared with primary repair+fibrin glue group, the differences in cavernous tissue healing with fibrosis and inflammation were statistically significant (p = 0.04 and 0.01, respectively). The primary repair+fibrin glue group, showed the best cavernous healing with fibrosis observed in only one rat. . There was no significant difference between the control group and the other groups according to cavernous tissue healing with fibrosis and inflammation (p = 0.11 and 0.12). Hyperemia was observed in the all groups of rats. Conclusions: Fibrin glue can be used in cavernoseal surgeries due to its adhesive and potentially anti-inflammatory features.

scholarly journals Fracture penis: rare occurrence

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.

scholarly journals Double penile fracture with complete urethral disruption following anal intercourse: a case report

2019 ◽  
Vol 6 (7) ◽  
pp. 2602
Author(s):  
Sasanka K. Barua ◽  
Sarbartha Kumar Pratihar ◽  
Rajeev T. P. ◽  
Saumar J. Baruah ◽  
Puskal K. Bagchi ◽  
...  
Keyword(s):  
Tunica Albuginea ◽  
Corpus Cavernosum ◽  
Anal Intercourse ◽  
Penile Fracture ◽  
Healthy Life ◽  
Urethral Wall ◽  
Urgent Surgery ◽  
Penile Injury ◽  
Extreme Care

Penile fracture remains a rare, under reported condition. It is defined as blunt trauma resulting in tear of tunica albuginea surrounding the corpus cavernosum during erection. Prompt diagnosis and early surgical repair are essential. Here we report a case of 37 years male with penile fracture involving both corpora cavernosum and complete urethral disruption. A 37-year-old man presented with penile injury during anal intercourse. Physical examination revealed a swollen, ecchymotic penis with dorsal angulation. Penile ultrasound showed tear in bilateral corpora cavernosa at ventral aspect with hematoma. On exploration tear in bilateral corpora with complete penile urethral disruption seen. Repair of corporal tear with end to end anastomotic urethroplasty done. He has normal voiding and sexual function at 4th months of follow up. The diagnosis of this condition is clinical, which is further augmented by high frequency sonography, which can detect exact site of the tear, also allows evaluation of penile vascularity. Evaluation of the urethra with sonography can help identify interruption of the urethral wall. As in our patient, double fracture involving corpora cavesnosa of both sides with complete urethral disruption, is rare entity. Urgent surgery with complete penile degloving is advocated and extreme care is needed not to miss any injury. Fracture of the penis is a rare surgical emergency. The diagnosis is clinical, however high-resolution sonography and colour Doppler are helpful. Early and prompt surgical intervention can restore normal voiding and erectile function to lead a healthy life.

scholarly journals Penile Fracture : Experience from a Tertiary Care Hospital

2019 ◽  
Vol 6 ◽  
Author(s):  
Malik Suhail Ahmad ◽  
Irfan Nazir Mir ◽  
Malik Faizan Abbass
Keyword(s):  
Tunica Albuginea ◽  
Tertiary Care ◽  
Corpus Cavernosum ◽  
Care Hospital ◽  
Postoperative Complication Rate ◽  
Penile Fracture ◽  
Jammu And Kashmir ◽  
History Of ◽  
The Mean ◽  
Erect Penis

Introduction: Penile fracture is a misnomer,penile fracture is defined as rupture of the tunica albuginea of one or both corpus cavernosum. The usual cause is abrupt bending of the erect penis by blunt trauma, which may occur during sexual intercourse, masturbation, rolling over on the bed or falling onto the erect penis. Diagnosis of penile fracture is made on the basis of history and physical examination.standard mode of management is surgical.Methods: This retrospective study was conducted in the department of surgery SMHS hospital srinagar ,(Jammu and Kashmir), extending over a period of about three and a half years from june 2013 to January 2017 . All patients with diagnosed penile fracture were included in this study. All except one patient were operated one the same day of admission.Results: out of a total of 50 patients studied ,the mean age of presentation was 26.7 years.Majority (56%)were below 30 years of age.21 (42%) of the patients were married.majority42% of the patients reported masturbation as cause of trauma,followed by vaginal intercourse in38% and rolling on erect penis in 20%.About 80% patients gave history of audible click/crackling sound.All patients had swelling and discolouration on examination,90% patients had penile deformity,only 36 % had palpable defect.Dopler USG was correct in 93% patients.Majority (44%) patients had defect less than 1cm.defect was mostly seen on right side (68%).most patients had proximal penile defect (56%). Mean hospital stay was 2.9 days. One patient (2%) had urethral trauma.Surgery had a recurrence of 2%.and a total postoperative complication rate of 10%.Conclusions: Penile fracture though reported rarely, is a common entity. Penile fracture is a urological emergency.Diagnosis is mainly on clinical grounds.Immediate surgical repair is the standard treatment of penile fracture.

Downregulation of miR-29b is associated with Peyronie’s disease

2021 ◽  
pp. 039156032110366
Author(s):  
Vinicius Genuino dos Santos ◽  
Gabriel Arantes dos Santos ◽  
Cristóvão Barbosa Neto ◽  
Nayara Izabel Viana ◽  
Ruan Pimenta ◽  
...  
Keyword(s):  
Messenger Rna ◽  
Tunica Albuginea ◽  
Corpus Cavernosum ◽  
Small Sample ◽  
Peyronie’S Disease ◽  
Control Group ◽  
Fibrous Plaque ◽  
Peyronie's Disease ◽  
Collagen Genes ◽  
First Time

Background: Peyronie’s disease (PD) is characterized by the formation of fibrous plaque in tunica albuginea, causing several problems in patients. The etiology of this disease is not fully understood, and there are few effective treatments. To better understand the molecular pathways of PD, we studied miR-29b, a microRNA that could be involved with this illness. MicroRNAs are endogenous molecules that act by inhibiting messenger RNA. MiR-29b regulates 11 of 20 collagen genes and the TGF-β1 gene, which are related to PD progression. Methods: We compared miR-29b expression in 11 patients with PD and 14 patients without PD (control group). For the patients with PD, we utilized samples from the fibrous plaque ( n = 9), from the tunica albuginea ( n = 11), and from the corpus cavernosum ( n = 8). For the control group, we utilized samples from the tunica albuginea ( n = 14) and from the corpus cavernosum ( n = 10). MiR-29b expression was determined by q-PCR. Results: We found a downregulation of miR-29b in the fibrous plaque, tunica albuginea and corpus cavernosum of patients with PD in comparison with the control group ( p = 0.0484, p = 0.0025, and p = 0.0016, respectively). Conclusion: Although our study has a small sample, we showed for the first time an evidence that the downregulation of miR-29b is associated with PD.

scholarly journals Penile fracture: Penoscrotal approach with degloving of penis after Magnetic Resonance Imaging (MRI)

2014 ◽  
Vol 86 (1) ◽  
pp. 39 ◽  
Author(s):  
Gabriele Antonini ◽  
Patrizio Vicini ◽  
Salvatore Sansalone ◽  
Giulio Garaffa ◽  
Antonio Vitarelli ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Tunica Albuginea ◽  
Corpus Cavernosum ◽  
Clinical History ◽  
Traumatic Rupture ◽  
Resonance Imaging ◽  
Penile Fracture ◽  
Dorsal Vein ◽  
Magnetic Resonance Imaging Mri

Fracture of the penis, a relatively uncommon emergency in Urology, consists in the traumatic rupture of the tunica albuginea of the corpus cavernosum. Examination and clinical history can be highly suspicious of penile fracture in the majority of cases and ultrasonography (USS) can be useful to identify the exact location of the tunical rupture, which is proximal in 2/3 of cases and therefore manageable through a penoscrotal approach. Although expensive and not readily available in the acute setting, Magnetic Resonance Imaging (MRI) may play a role in the differential diagnosis with rupture of a circumflex or dorsal vein of the penis or when the tunical rupture is not associated with tear of the overlying Buck’s fascia. This form of imaging is more sensitive than USS at identifying the presence of a tunical tear. The treatment of choice is immediate surgical repair, which allows preserving erectile function and minimizing corporeal fibrosis.

scholarly journals Penile fracture: A rare case of simultaneous rupture of the one corpus cavernosum and complete urethral rupture

2015 ◽  
Vol 72 (1) ◽  
pp. 60-62
Author(s):  
Djordje Nale ◽  
Nebojsa Bojanic ◽  
Predrag Nikic
Keyword(s):  
Tunica Albuginea ◽  
Corpus Cavernosum ◽  
Traumatic Rupture ◽  
Corpus Spongiosum ◽  
Penile Fracture ◽  
Voiding Function ◽  
The One ◽  
The Right ◽  
Urethral Rupture ◽  
Simultaneous Rupture

Introduction. Penile fracture is a traumatic rupture of tunica albuginea and the tumescent corpora cavernosa due to the nonphysiological bending of the penile shaft, presenting with or without rupture of corpus spongiosum and urethra. The incidence of concomitant injury of the urethra is 0-38%. Complete urethral rupture is rare, but it is almost always associated with bilateral corporeal injury. Case report. We presented a patient with complete urethral rupture, and rupture of the right cavernous body. According to the available literature, this case is extremely rare. Conclusion. Fracture of the penis is relatively uncommon and is considered a urologic emergency. Prompt surgical exploration and repair can preserve erectile and voiding 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.

Abordagem Tardia do Trauma de Pênis: Relato de Caso/Late Approach of Penile Trauma: Case Report.

1970 ◽  
Vol 5 (2) ◽  
pp. 130-138
Author(s):  
Miria Freitas Andrade ◽  
Nayara de Abreu Cordeiro ◽  
Rodrigo Teixeira Siniscalchi
Keyword(s):  
Case Report ◽  
Surgical Approach ◽  
Surgical Intervention ◽  
Tunica Albuginea ◽  
Corpus Cavernosum ◽  
Penile Fracture ◽  
Recommended Treatment ◽  
Penile Trauma ◽  
Patient Table ◽  
Immediate Surgery

RESUMOIntrodução: A fratura de pênis trata-se de uma urgência urológica incomum e pode ser definida como trauma peniano fechado que resulta na ruptura da túnica albugínea. A apresentação clínica do quadro é descrita pelo paciente como um “estalido” ocorrido pelo rompimento do corpo cavernoso, acompanhado de dor, detumescência peniana imediata, edema e hematoma. Durante o exame observa-se o desvio peniano para o lado oposto ao da fratura. O diagnóstico da fratura peniana é clínico. O tratamento preconizado seria a intervenção cirúrgica com identificação do local do trauma, evacuação do hematoma, hemostasia e sutura do corpo cavernoso. Devendo ser associado antibioticoterapia profilática. Casuística: O presente relato tem como objetivo descrever um quadro atípico de fratura de pênis em que o paciente não apresentou “estalido”, nem detumescência como nos casos relatados na literatura. Além disso, a conduta tomada frente ao trauma foi diferenciada, visto que a abordagem cirúrgica ocorreu 18 dias após a fratura. Discussão: O tratamento preconizado, de intervenção cirúrgica imediata foi contraindicada em decorrência do edema volumoso que o paciente apresentava no momento do atendimento inicial. A equipe médica optou por reduzir o edema com o uso de anti-inflamatórios e a abordagem cirúrgica foi realizada tardiamente. Diferentemente do que foi encontrado na literatura, a intervenção cirúrgica é preconizada como tratamento imediato. Conclusão: Concluiu-se que a conduta adotada, reduzir o edema local e abordar cirurgicamente em um segundo momento, foi bem indicada uma vez que o paciente apresentou uma boa evolução.Palavras chave: Fratura, Pênis, Trauma ABSTRACTIntroduction: The penis fracture is an unusual urological emergency and can be defined as closed penile trauma resulting in rupture of the tunica albuginea. The clinical presentation of the patient table is described as a "click" occurred by disruption of the corpus cavernosum, followed by pain, immediate detumescence penile edema and hematoma. During the examination one can see the penile deviation to the opposite side of the fracture. The diagnosis of penile fracture is clinical. The recommended treatment would be surgical intervention with identification of the trauma site, hematoma evacuation, hemostasis and suturing of the corpus cavernosum. It should be associated with prophylactic antibiotics. Case Report: This report aims to describe an atypical case of penile fracture in which the patient did not "click" nor there was detumescence as in the cases reported in the literature. The therapeutic decision facing the trauma was a surgical approach after 18 days of fracture, with clinical treatment in this period. The patient had no complications during the period in which he was assisted. Discussion: Immediate surgery, which is the recommended treatment, was contraindicated in this case due to the massive swelling that the patient showed at the time of initial treatment. The medical team chose to reduce the edema with the use of anti-inflammatory drugs and surgical approach was performed afterwards. Unlikely what was found in the literature, according surgical intervention is recommended as an immediate treatment. Conclusion: This treatment was effective in reducing local edema and made it possible to have the surgical approach in a second moment, being well indicated once the patient showed good evolution.Keywords: Fracture, Penis, Trauma.

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