Penile Fracture: Presentation, Diagnosis and the Treatment

  • Fayaz Ahmad Najar Registrar Postgraduate Department of Surgery, GMC Srinagar.
  • Raja Nadeem Lecturer Postgraduate Department of Surgery, GMC Srinagar.
  • Peer Hilal Ahmad Makhdoomi Registrar Postgraduate Department of Surgery, GMC Srinagar.
  • Syed Shakeeb PG Postgraduate Department of Surgery, GMC Srinagar.
Keywords: Fracture, Corpora, Tear.

Abstract

Background: Penile fractures typically occur when the engorged penile corpora are forced to buckle and literally “pop” under the pressure of a blunt sexual trauma, due to slippage of the penis out of the vagina during intercourse and the treatment is often delayed due to embarrassment felt by the patient. The condition is one of the uncommon emergencies but fully diagnosed through history and clinical examination alone. 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.

Methods: The diagnosis of penile fracture describes the traumatic rupture of the tunica albuginea of an erect penis. Although a majority of cases can be diagnosed from the history and physical examination alone, radiographic studies, including retrograde urethrography and corporal cavernosography can aid in the diagnosis of this unusual cases.

Results: The patient reports to the surgical emergency within 24 to 48 hours of injury and can be handled successfully with minimum complications. The immediate surgical exploration with evacuation of the hematoma and repair of tunica albuginea defect is the ideal and most efficacious treatment of such a condition.

Conclusions: Postoperatively, the patient may have penile bending/torsion and erectile dysfunction, but this is often self-limiting.

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References

1. McDougal WS, Wein AJ, Kavoussi LR, et al. Campbell-Walsh Urology 10th Edition Review: Elsevier Health Sciences; 2016.
2. Shariat M, Sufian M. Role of Ultrasound in Diagnostic Aid of a Case of Penile Fracture. Shiraz E Medical Journal 2008; 9:158-62.
3. Lee SH, Bak CW, Choi MH, et al. Trauma to male genital organs: a 10-year review of 156 patients, including 118 treated by surgery. BJU Int 2008; 101:211-5.
4. Bryk DJ, Zhao LC. Guideline of guidelines: a review of urological trauma guidelines. BJU Int2016; 117:226-34. 10.1111/bju.13040.
5. Haas CA, Brown SL, Spirnak JP. Penile fracture and testicular rupture. World J Urol 1999; 17:101-6. 10.1007/s003450050114.
6. Gontero P. Sidhu P, Muir GH. Penile fracture repair: assessment of early results and complications using color doppler ultrasound. Int J Imp Res 2000: 12: 125-9.
7. Narayansingh V, Raju JC. Fracture of the penis. Br J Surg 1985; 72: 309-16
8. El-Bahansawy MS, Gomha MA. Penile fractures: the successful outcome of immediate surgical intervention. Int J Imp Res 2000; 12: 273-7.
9. Kalash SS. Young JD. Fracture of the penis: controversy of surgi­cal versus conservative treatment. Urology 1984; 24: 21-4.
10. Cummings M. Parra RO, Boullier JA. Delayed repair of penile frac­ture. J Trauma 1998; 45: 153-4.
11. Morey AF, Dugi DD. Genital and lower urinary tract trauma. Campbell Walsh urology. 10th edition. Saunders: 2012; 2507-2508.
12. Penson DF. Seftel AD, Krane RJ, Frohrib D, Goldstein I. The hemodynamic pathophysiology of impotence following blunt trauma to the erect penis. J Urol 1992: 148: 1171-80.
13. Javaad Zargooshi. Penile fracture in Kermanshah, Iran: The long­term results of surgical treatment. Br J Urol 2002; 89: 890-4.
14. Asgari MA, Hossein SY, Safarinejad MR. Samadzedeh B, Bardideh AR. Penile fractures: evaluation, therapeutic approaches and long­term results. J Urol 1996; 155: 148-9.
Published
2019-12-24
How to Cite
1.
Najar FA, Nadeem R, Makhdoomi PHA, Shakeeb S. Penile Fracture: Presentation, Diagnosis and the Treatment. Int Arch BioMed Clin Res [Internet]. 2019Dec.24 [cited 2020Feb.20];5(4):GS4-GS6. Available from: https://iabcr.org/index.php/iabcr/article/view/529
Section
ORIGINAL ARTICLES ~ General Surgery