Presentation, Management, and Outcomes of Penile Fractures

Abstract

Background: Penile fractures are due to a traumatic rupture of the penile tunica albuginea of the corpus cavernosum and may result from numerous etiologies. The purpose of our review is to describe the etiology, management, and outcomes of penile fractures. Methods: A literature review was performed. Results: The diagnosis of penile fractures is usually made clinically but can also be made with the assistance of ultrasound or MRI (magnetic resonance imaging) imaging when unclear. Cystoscopy should be performed when urethral involvement is suspected. Surgical management should be initiated promptly after the diagnosis, and within 24 hours of presentation. Surgical management can include the subcoronal or penoscrotal approach, although the penoscrotal approach is preferred when imaging confirms the location of the injury to be ventral and proximal, due to the reduced morbidity of this technique. Complications following penile fractures include erectile dysfunction, penile curvature, and voiding symptoms, but the incidence of complications is reduced if surgical intervention is performed promptly after fracture presentation. A rare cause of penile fractures is collagenase clostridium histolyticum injection, and these cases should predominantly be managed conservatively. Conclusions: Penile fractures can present in various ways and must be managed surgically and promptly after the diagnosis is made.

Keywords

• penile fractures
• rupture of corpus cavernosum
• collagenase clostridium histolyticum
• immediate vs. delayed management of penile fracture