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 ◽  
...  

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 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


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.


Author(s):  
Malik Suhail Ahmad ◽  
Irfan Nazir Mir ◽  
Malik Faizan Abbass

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.


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.


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.


F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 1828
Author(s):  
Felipe Mercado-Olivares ◽  
J. Antonio Grandez-Urbina ◽  
Giomar Farfan-Daza ◽  
Juan Pacheco-Sauñe ◽  
Luciano Nuñez-Bragayrac

Penile fracture is an underreported surgical emergency. It usually occurs as a single rupture of the tunica albuginea in one of two corpora cavernosa; a rupture of both masses is an uncommon finding. We report a case of a young male who presented to the emergency department two hours after sustaining penile trauma. Prompt surgical exploration was performed four hours post-injury. He was found to have one fracture on each corpora cavernosa, without urethral injury, which were repaired successfully. The patient had a favorable recovery and was discharged on the third postoperative day without complications. The aim of this report is to highlight the importance of complete degloving of the penile shaft for a meticulous search during surgery to avoid missed injuries. This approach will ensure a successful outcome avoiding physical and psychological disabilities.


2013 ◽  
Vol 7 (5-6) ◽  
pp. 347 ◽  
Author(s):  
Giovanni B. Di Pierro ◽  
Luca Iannotta ◽  
Michele Innocenzi ◽  
Caterina Gulia ◽  
Vincenzo Gentile ◽  
...  

A 22-year-old man reported cracking sound and acute pain during sexual intercourse followed by rapid penile detumescence and ecchymosis. He experienced more pain because he could not urinate and had a palpably full bladder. Moreover, his urethra was bleeding. Physical examination revealed swollen, ecchymotic and deviated penis and penis ultrasonography showed an injury of the tunica albuginea and Buck’s fascia with an expanding hematoma. Suprapubic catheter was positioned. Surgical exploration revealed a tear of tunica albuginea of both corpora cavernosa and complete urethral dissection. End-to-end urethral anastomosis and suture of corpora cavernosa lesion were performed. Vescical catheter was mantained for 6 days and suprapubic catheter for 3 months to allow a complete urethral healing. A pseudo diverticulum was found atanastomosis level on the urethrocistography 1 month after surgery. It disappeared by allowing micturition via the suprapubic catheter. The patient presented regular urinary flow and physiological erections 30 days later. In our experience, prompt surgical repair preserved erectile function and keeping the suprapubic catheter protected the urethra; this was the correct management for repairing the urethral lesion.


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.


2020 ◽  
Vol 7 (51) ◽  
pp. 3070-3073
Author(s):  
Fayaz Ahmad Najar ◽  
Peer Hilal Ahmad Makhdoomi ◽  
Tajamul Rashid

BACKGROUND Penile fractures occur when the engorged penile corpora are forced to buckle and “pop” under the pressure of a blunt sexual trauma, due to slippage of the penis out of the vagina during intercourse. Patients typically describe that a “plop” sound was followed by immediate de-tumescence, severe pain, and swelling, called as “egg-plant” deformity, as a result of the injury. The immediate surgical exploration with evacuation of the haematoma and repair of tunica albuginea defect is the ideal treatment. METHODS Over a period of more than 3 years between May 2015 and January 2019 we have treated 26 patients with penile fractures. All of them presented within 24 hours after sustaining the injury. None had associated urethral injury. Apart from clinical examination and history the investigation most commonly used by us to aid diagnosis was Ultrasound (USG) and colour doppler which helped in identifying the site and size of the defect as well as the blood collections. All were treated by surgical exploration. RESULTS Patients were discharged either on 2nd or 3rd post-operative day. None of our patients developed any postoperative wound infection. Post-operative hematoma developed in 01 patient. 01 patient had complaints of slight bend of the penis to the affected side but with no sexual problem. There was no history of erectile dysfunction in any of these patients. CONCLUSIONS To diagnose penile fracture, our study relied on history and physical examination mainly and did not recommend imaging, except for, in patients with possible urethral injuries. Immediate surgical intervention can make good functional results and surgical exploration can be considered in all cases of penile fractures. The procedure is simple with minimal morbidity, low morbidity and short hospital stay. KEYWORDS Fracture, Corpora, Tear


2019 ◽  
Vol 6 (7) ◽  
pp. 2602
Author(s):  
Sasanka K. Barua ◽  
Sarbartha Kumar Pratihar ◽  
Rajeev T. P. ◽  
Saumar J. Baruah ◽  
Puskal K. Bagchi ◽  
...  

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.


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