Penile Fracture, Surgical Success and Complication Rate in 26 Cases

Naser Alfgi; Saliem Abuaniza; Abdulghany Hussien

doi:doi:10.11648/j.ijcu.20190302.12

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Penile Fracture, Surgical Success and Complication Rate in 26 Cases

Naser Alfgi, Saliem Abuaniza, Abdulghany Hussien

Received: 19 September 2019 Accepted: 29 September 2019 Published: 20 October 2019

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Abstract

A fracture of the penis is defined as the rupture of the tunica albuginea of corpora cavernosa as a result of blunt trauma to the erect penis commonly occurring during sexual intercourse or masturbation. Our objective is to present our experience in the management of penile fracture, surgical success and the complication rate. This study took place in the Urology Department of the Tripoli Medical Center on 26 patients in the form of a retrospective study between August 2003 and July 2018. The ages of the patients were between 19 and 61 years old (mean 34.23 years). The diagnosis was based on history and clinical examination. A circumferential sub coronal incision was made followed by degloving the penis to its base. The hematoma was evacuated and the tear was repaired using absorbable, interrupted stitches and the skin was closed with 3/0 undyed vicryl. Cefotriaxon 1 gm IV was given pre-operatively and continued for 5 days post-operative and diazepam 5 mg tab was given twice daily. The cause of penile fracture was masturbation in 11 patients. Intercourse was the cause in 9 cases and 6 were caused by rolling over the erect penis during sleep. All of the patients presented with swelling and ecchymosis and 18 patients underwent surgery within the first 24 hrs while 8 patients were operated on in the 2nd day. After six months of follow up, 19 patients (73.1%) were without complaint, of which 17 (89.47%) of them were operated on within the first 24 hrs and 2 patients (10.53%) were operated on in the 2nd day. Within the group, 7 patients (26.9%) had complications of which 6 patients were operated on after 24 hrs from the time of trauma and one patient who was operated on in the first 24 hrs and complained of painless penile deviation. Three patients had complications with penile deviation and with painful erection while 3 patients had complications of penile deviation. This experience showed that penile fracture is a rare urological emergency. Early surgical correction of penile fractures can be successful in preserving normal erections without significant complications whilst delayed operative management is associated with complications such as penile deviation and painful erection.

DOI	10.11648/j.ijcu.20190302.12
Published in	International Journal of Clinical Urology (Volume 3, Issue 2, December 2019)
Page(s)	36-39
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Penile Fracture, Tunica Albuginea, Sub-coronal Incision, Corpus Cavernosu

References

[1]	Xu MX, Zhou Z, Yao HJ, Zhang K, Da J, Zhang M, Wang Z, Lu MJ. Comparison of different approaches to the surgical treatment of penile fractures: quicker return to sexual function with longitudinal incisions. International journal of impotence research. 2016 Jul; 28 (4): 155.
[2]	Shakya P, Choudhary B, Tripathi K, Sawai M. Penile fracture rare urological emergency. International Surgery Journal. 2016 Dec 13; 3 (1): 420-1.
[3]	Amer T, Wilson R, Chlosta P, AlBuheissi S, Qazi H, Fraser M, Aboumarzouk OM. Penile fracture: a meta-analysis. Urologia internationalis. 2016; 96 (3): 315-29.
[4]	Yalom ID. Psicoterapia esistenziale. Neri Pozza Editore; 2018 Dec 28.
[5]	Barros R, Schul A, Ornellas P, Koifman L, Favorito LA. Impact of Surgical Treatment of Penile Fracture on Sexual Function. Urology. 2019 Apr 1; 126: 128-33.
[6]	Girgin R. Complete Urethral Rupture Related with Penile Fracture Occurring during Sexual Intercourse: A Case Report and Review of the Literature/Cinsel Iliski Nedeniyle Olusmus Penil Fraktur ile Iliskili Tam Uretral Ruptur: Olgu Sunumu ve Literatur Taramasi. Journal of Urological Surgery. 2018 Jun 1; 5 (2): 112-6.
[7]	Dell’Atti L. The role of ultrasonography in the diagnosis and management of penile trauma. Journal of ultrasound. 2016 Sep 1; 19 (3): 161-6.
[8]	Persaud S, Persaud M, Naraynsingh V. Fracture of the Penis: A Review. UROLOGY. 2019 Apr.
[9]	Kumar L, Tiwari R, Arya MC, Sandhu A, Vasudeo V, Baid M. A tertiary center experience of fracture penis: Early surgical management with a clinical diagnosis. Urological Science. 2018 Nov 1; 29 (6): 298.
[10]	Blair BM, Vilson F, Kocher NJ, Kloniecke E, Clark JY. Longitudinal Rupture of Distal Corpus Cavernosum With Concomitant Urethral Injury: An Uncommon Result of a Common Mechanism. Urology. 2018 Aug 1; 118: e5-6.
[11]	Wespes E, Libert M, Simon J, Schulman CC. Fracture of the penis: conservative versus surgical treatment. Eur Urol. 2008, 13: 166-168.
[12]	Seaman EK, Santarosa RP, Walton GR. Immediate repair: key to managing the fractured penis. Contemp Urol. 2005; 5: 13.
[13]	Vahidi S, Karami H, Maleki H. Penile fracture with bilateral corporeal tears and complete disruption of the urethra following anal intercourse: a case report and review of literature. Journal of Case Reports. 2018; 6 (4): 42-4.

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APA Style

Naser Alfgi, Saliem Abuaniza, Abdulghany Hussien. (2019). Penile Fracture, Surgical Success and Complication Rate in 26 Cases. International Journal of Clinical Urology, 3(2), 36-39. https://doi.org/10.11648/j.ijcu.20190302.12

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ACS Style

Naser Alfgi; Saliem Abuaniza; Abdulghany Hussien. Penile Fracture, Surgical Success and Complication Rate in 26 Cases. Int. J. Clin. Urol. 2019, 3(2), 36-39. doi: 10.11648/j.ijcu.20190302.12

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AMA Style

Naser Alfgi, Saliem Abuaniza, Abdulghany Hussien. Penile Fracture, Surgical Success and Complication Rate in 26 Cases. Int J Clin Urol. 2019;3(2):36-39. doi: 10.11648/j.ijcu.20190302.12

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@article{10.11648/j.ijcu.20190302.12,
  author = {Naser Alfgi and Saliem Abuaniza and Abdulghany Hussien},
  title = {Penile Fracture, Surgical Success and Complication Rate in 26 Cases},
  journal = {International Journal of Clinical Urology},
  volume = {3},
  number = {2},
  pages = {36-39},
  doi = {10.11648/j.ijcu.20190302.12},
  url = {https://doi.org/10.11648/j.ijcu.20190302.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcu.20190302.12},
  abstract = {A fracture of the penis is defined as the rupture of the tunica albuginea of corpora cavernosa as a result of blunt trauma to the erect penis commonly occurring during sexual intercourse or masturbation. Our objective is to present our experience in the management of penile fracture, surgical success and the complication rate. This study took place in the Urology Department of the Tripoli Medical Center on 26 patients in the form of a retrospective study between August 2003 and July 2018. The ages of the patients were between 19 and 61 years old (mean 34.23 years). The diagnosis was based on history and clinical examination. A circumferential sub coronal incision was made followed by degloving the penis to its base. The hematoma was evacuated and the tear was repaired using absorbable, interrupted stitches and the skin was closed with 3/0 undyed vicryl. Cefotriaxon 1 gm IV was given pre-operatively and continued for 5 days post-operative and diazepam 5 mg tab was given twice daily. The cause of penile fracture was masturbation in 11 patients. Intercourse was the cause in 9 cases and 6 were caused by rolling over the erect penis during sleep. All of the patients presented with swelling and ecchymosis and 18 patients underwent surgery within the first 24 hrs while 8 patients were operated on in the 2nd day. After six months of follow up, 19 patients (73.1%) were without complaint, of which 17 (89.47%) of them were operated on within the first 24 hrs and 2 patients (10.53%) were operated on in the 2nd day. Within the group, 7 patients (26.9%) had complications of which 6 patients were operated on after 24 hrs from the time of trauma and one patient who was operated on in the first 24 hrs and complained of painless penile deviation. Three patients had complications with penile deviation and with painful erection while 3 patients had complications of penile deviation. This experience showed that penile fracture is a rare urological emergency. Early surgical correction of penile fractures can be successful in preserving normal erections without significant complications whilst delayed operative management is associated with complications such as penile deviation and painful erection.},
 year = {2019}
}

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TY - JOUR
T1 - Penile Fracture, Surgical Success and Complication Rate in 26 Cases
AU - Naser Alfgi
AU - Saliem Abuaniza
AU - Abdulghany Hussien
Y1 - 2019/10/20
PY - 2019
N1 - https://doi.org/10.11648/j.ijcu.20190302.12
DO - 10.11648/j.ijcu.20190302.12
T2 - International Journal of Clinical Urology
JF - International Journal of Clinical Urology
JO - International Journal of Clinical Urology
SP - 36
EP - 39
PB - Science Publishing Group
SN - 2640-1355
UR - https://doi.org/10.11648/j.ijcu.20190302.12
AB - A fracture of the penis is defined as the rupture of the tunica albuginea of corpora cavernosa as a result of blunt trauma to the erect penis commonly occurring during sexual intercourse or masturbation. Our objective is to present our experience in the management of penile fracture, surgical success and the complication rate. This study took place in the Urology Department of the Tripoli Medical Center on 26 patients in the form of a retrospective study between August 2003 and July 2018. The ages of the patients were between 19 and 61 years old (mean 34.23 years). The diagnosis was based on history and clinical examination. A circumferential sub coronal incision was made followed by degloving the penis to its base. The hematoma was evacuated and the tear was repaired using absorbable, interrupted stitches and the skin was closed with 3/0 undyed vicryl. Cefotriaxon 1 gm IV was given pre-operatively and continued for 5 days post-operative and diazepam 5 mg tab was given twice daily. The cause of penile fracture was masturbation in 11 patients. Intercourse was the cause in 9 cases and 6 were caused by rolling over the erect penis during sleep. All of the patients presented with swelling and ecchymosis and 18 patients underwent surgery within the first 24 hrs while 8 patients were operated on in the 2nd day. After six months of follow up, 19 patients (73.1%) were without complaint, of which 17 (89.47%) of them were operated on within the first 24 hrs and 2 patients (10.53%) were operated on in the 2nd day. Within the group, 7 patients (26.9%) had complications of which 6 patients were operated on after 24 hrs from the time of trauma and one patient who was operated on in the first 24 hrs and complained of painless penile deviation. Three patients had complications with penile deviation and with painful erection while 3 patients had complications of penile deviation. This experience showed that penile fracture is a rare urological emergency. Early surgical correction of penile fractures can be successful in preserving normal erections without significant complications whilst delayed operative management is associated with complications such as penile deviation and painful erection.
VL - 3
IS - 2
ER -

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Author Information

Naser Alfgi

Tripoli Medical Center, Urology Department, Tripoli, Libya
Saliem Abuaniza

Tripoli Medical Center, Urology Department, Tripoli, Libya
Abdulghany Hussien

Tripoli Medical Center, Urology Department, Tripoli, Libya

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APA Style

Naser Alfgi, Saliem Abuaniza, Abdulghany Hussien. (2019). Penile Fracture, Surgical Success and Complication Rate in 26 Cases. International Journal of Clinical Urology, 3(2), 36-39. https://doi.org/10.11648/j.ijcu.20190302.12

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ACS Style

Naser Alfgi; Saliem Abuaniza; Abdulghany Hussien. Penile Fracture, Surgical Success and Complication Rate in 26 Cases. Int. J. Clin. Urol. 2019, 3(2), 36-39. doi: 10.11648/j.ijcu.20190302.12

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AMA Style

Naser Alfgi, Saliem Abuaniza, Abdulghany Hussien. Penile Fracture, Surgical Success and Complication Rate in 26 Cases. Int J Clin Urol. 2019;3(2):36-39. doi: 10.11648/j.ijcu.20190302.12

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@article{10.11648/j.ijcu.20190302.12,
  author = {Naser Alfgi and Saliem Abuaniza and Abdulghany Hussien},
  title = {Penile Fracture, Surgical Success and Complication Rate in 26 Cases},
  journal = {International Journal of Clinical Urology},
  volume = {3},
  number = {2},
  pages = {36-39},
  doi = {10.11648/j.ijcu.20190302.12},
  url = {https://doi.org/10.11648/j.ijcu.20190302.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcu.20190302.12},
  abstract = {A fracture of the penis is defined as the rupture of the tunica albuginea of corpora cavernosa as a result of blunt trauma to the erect penis commonly occurring during sexual intercourse or masturbation. Our objective is to present our experience in the management of penile fracture, surgical success and the complication rate. This study took place in the Urology Department of the Tripoli Medical Center on 26 patients in the form of a retrospective study between August 2003 and July 2018. The ages of the patients were between 19 and 61 years old (mean 34.23 years). The diagnosis was based on history and clinical examination. A circumferential sub coronal incision was made followed by degloving the penis to its base. The hematoma was evacuated and the tear was repaired using absorbable, interrupted stitches and the skin was closed with 3/0 undyed vicryl. Cefotriaxon 1 gm IV was given pre-operatively and continued for 5 days post-operative and diazepam 5 mg tab was given twice daily. The cause of penile fracture was masturbation in 11 patients. Intercourse was the cause in 9 cases and 6 were caused by rolling over the erect penis during sleep. All of the patients presented with swelling and ecchymosis and 18 patients underwent surgery within the first 24 hrs while 8 patients were operated on in the 2nd day. After six months of follow up, 19 patients (73.1%) were without complaint, of which 17 (89.47%) of them were operated on within the first 24 hrs and 2 patients (10.53%) were operated on in the 2nd day. Within the group, 7 patients (26.9%) had complications of which 6 patients were operated on after 24 hrs from the time of trauma and one patient who was operated on in the first 24 hrs and complained of painless penile deviation. Three patients had complications with penile deviation and with painful erection while 3 patients had complications of penile deviation. This experience showed that penile fracture is a rare urological emergency. Early surgical correction of penile fractures can be successful in preserving normal erections without significant complications whilst delayed operative management is associated with complications such as penile deviation and painful erection.},
 year = {2019}
}

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