Keywords : erectile dysfunction

Role of Early Surgical Repair of Penile Fractures

Malath Anwer Hussein

Iraqi Postgraduate Medical Journal, 2012, Volume 11, Issue 3, Pages 330-335

Fracture of the penis is a relatively rare condition that is defined as a rupture of the tumescent corpora cavernosa as a result of blunt trauma, most commonly during sexual intercourse or masturbation, which needs urgent surgical intervention to achieve good postoperative outcome.
To study the etiology and outcome of early surgical repair in patients presenting with fracture of penis.
This study carried out in the surgical departments of Al-Kindy teaching Hospital from June 2005 to March 2011. Patients with the clinical diagnosis of fracture penis were admitted and operated. All patients were admitted to the hospital 2 to 10 hours after injury. No invasive investigation was used for diagnosis. The treatment was surgical in all cases with subcoronal circumferential degloving incision, evacuation of hematoma and primary suturing of the tunica tear with absorbable suture. No drain was used and a light compression dressing was done in all patients. Catheter was removed on the second postoperative day. All patients had were followed up for 3-12 months postoperatively.
During the study period 30 patients aged 19 to 42 years, presented with a penile fracture were operated for fracture penis. Mean age at presentation was 31 years. The commonest cause of fracture penis was due to sexual intercourse. The commonest mode of presentation was with a cracking sound, local pain and immediate detumescence (90%, 96% & 100% respectively). All patients showed penile haematoma. None of the patients had urethral bleeding. All patients were surgically treated; at the time of surgery unilateral albugineal rupture was found in all cases. With follow up all cases were able to achieve an adequate erection. No complications such as deformations, penile plaque or erectile dysfunction were reported. Average hospital stay was 3.4 days.
The commonest cause of fracture penis is due to sexual intercourse. The best treatment option is immediate surgical repair to obtain better functional outcome and to avoid potential complications