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Penile Fracture

Complete list of fracture information

 is an injury caused by the rupture of the tunica albuginea, which envelopes the corpus cavernosum penis. It is an uncommon injury, most often caused by a blunt trauma to an erect penis. A popping or cracking sound, significant pain, immediate detumescence, and skin hematoma of various sizes are commonly associated with the event. Penile fracture is generally considered a medical emergency, and emergency medical surgical repair is the usual treatment. Delay in seeking treatment increases the complication rate. Non-surgical approaches result in 10%-50% complication rates including erectile dysfunction, permanent penile curvature, damage to the urethra, and pain during sexual intercourse.

In the western hemisphere the most common cause, accounting for about 30%-50% of cases, is intercourse. Of those, woman-on-top positions resulting in impact against the female pelvis or perineum and bending laterally are most common. In Middle Eastern countries the common cause is physical manipulation of the penis to remove an erection[1] [2].

Symptoms of Penile Fracture

  • Immediate loss of erection
  • Pain
  • Bruising
  • A cracking noise
  • Bleeding from the urethra
     
 

Treatment of Penile Fracture

Advice should be sought quickly. Key elements in treating a fractured penis are:

  • pain relief
  • ice packs (always cover with a cloth before applying to skin)
  • support
  • anti-inflammatory drugs.

This regime has satisfactory results in about 80 per cent of patients but in the rest, residual pain and deformity may lead to difficulty with sex. These patients need a urethrogram (a test that shows whether the urethral tube is intact) to exclude urethral damage. If the urethra is not damaged, any collection of blood (haematoma) is drained and repair is carried out to the damaged corpora and tunica. One report of a series of 17 repairs showed that after surgery all patients had painless erections and comfortable sex; only two patients were left with angulation ('bent' penis). Urethral injuries should always be repaired but urethral stricture (narrowing) occurs long term in up to 20 per cent of men after surgery.
 

 

 
 
 
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