Penile Fracture - Our Initial Experience and Outcome

Abstract

Fayaz Ahmad Najar1 , Peer Hilal Ahmad Makhdoomi2 , Tajamul Rashid3

BACKGROUND Penile fractures occur when the engorged penile corpora are forced to buckle and “pop” under the pressure of a blunt sexual trauma, due to slippage of the penis out of the vagina during intercourse. 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. The immediate surgical exploration with evacuation of the haematoma and repair of tunica albuginea defect is the ideal treatment. METHODS Over a period of more than 3 years between May 2015 and January 2019 we have treated 26 patients with penile fractures. All of them presented within 24 hours after sustaining the injury. None had associated urethral injury. Apart from clinical examination and history the investigation most commonly used by us to aid diagnosis was Ultrasound (USG) and colour doppler which helped in identifying the site and size of the defect as well as the blood collections. All were treated by surgical exploration. RESULTS Patients were discharged either on 2nd or 3rd post-operative day. None of our patients developed any postoperative wound infection. Post-operative hematoma developed in 01 patient. 01 patient had complaints of slight bend of the penis to the affected side but with no sexual problem. There was no history of erectile dysfunction in any of these patients. CONCLUSIONS To diagnose penile fracture, our study relied on history and physical examination mainly and did not recommend imaging, except for, in patients with possible urethral injuries. Immediate surgical intervention can make good functional results and surgical exploration can be considered in all cases of penile fractures. The procedure is simple with minimal morbidity, low morbidity and short hospital stay.

image