INTRODUCTION:The erect penis is very vulnerable to blunt trauma, which is mostly sustained during sexual intercourse or through vigorous manipulations during masturbation or other violent sexual activities. These actions may lead to a fracture of the penis. The purpose of this retrospective study is to review the effect of early surgical exploration and repair of penile fractures and to report the overall healing of these injuries and the patient's ability to regain erectile function.
METHODS: A total of 20 patients presented with a fractured penis between October 1999 and November 2009. Their mean age was 27 years (range, 16-48 years). All were managed with surgical repair within 24 hours of the injury by the same surgeon (HA). Postoperative follow-up occurred monthly up to 6 months. The outcome measures were: (1) patient satisfaction with the cosmetic results, and (2) patient satisfaction with erectile function, as determined by the International Index of Erectile Function (IIEF). Complications during the follow-up period were summarized.
RESULTS: All 20 patients had successful wound healing, although 4 patients who were HIV-positive developed superficial wound infections that were treated by antibiotics. All patients reported normal psychogenic response, nocturnal erection, and full sexual activity at 3 months after surgery. The mean IIEF score was 23.5 out of a total 25 points (range, 22-25).
CONCLUSION: A fractured penis is a urological emergency that is best treated with immediate surgical exploration and repair of the tunica albuginea and any associated injuries. Surgical repair minimizes the incidence of erectile dysfunction.
Hassan Ashmawy
Submitted: November 4, 2010
Accepted for Publication: November 30, 2010
KEYWORDS: Fractured penis; Urethral injury; Erectile dysfunction; Surgical management.
CORRESPONDENCE: Hassan Mahmoud Ashmawy, Consultant Urologist, Mpilo Central Hospital, Senior Lecturer School of Medicine, National University of Science and Technology (NUST), P. O. Box 3682, Bulawayo, Zimbabwe ( ).
CITATION: UroToday Int J. 2011 Feb;4(1):art4.
doi: 10.3834/uij.1944-5784.2011.02.04