A tertiary center experience of fracture penis: Early surgical management with a clinical diagnosis

Abstract

Introduction: Fracture penis is uncommon and often a result of sexual trauma. Diagnosis remains clinical and early surgical management is advocated. Herein, we share our experience of 20 such cases. Materials and Methods: Twenty fracture penis patients presented between August 2014 and April 2017 were included. Patients' data were retrieved retrospectively using case sheets and followed by outpatient department visits and telephonically. Eighteen patients had penile exploration while two patients were managed conservatively. Erectile and voiding functions were assessed by asking single question to the patient, which was limited to only two options in the form of normal and abnormal. All patients were followed up for a minimum of up to 6 months. Results: The patients were aged between 20 and 60 years (mean 37.7 years). Mean timing of presentation was 28.8 h (range 2 h to 7 days). Mean follow-up was 22.5 months (6–42 months). There were no long-term postoperative complications. Eighteen patients had coital trauma, one unmarried patient had a history of manipulation of erect penis, while one patient had a fall-on erect penis. Three patients had associated urethral injury. All patients had almost the same potency as preoperatively, but for one who had erectile dysfunction for a short period recovered spontaneously on tablet sildenafil. No patient had long-term voiding dysfunction, penile curvature, or sexual dysfunction. Conclusion: History and clinical examination clinch the diagnosis. Considering it as a urological emergency, radiological imaging is not required routinely. Early surgical repair preserves the potency and voiding functions.

Keywords

• Fracture
• penile
• urethra