Pattern of presentation and surgical management of penile fractures in a semi-urban African teaching hospital: Case reports and literature review

Abstract

Introduction: Penile fracture is relatively rare and also under-reported in our environment. There seem to be a gradual change in this pattern however, as we managed six patients over a two-year period. Objective: To present the peculiarities of penile fracture presentation and surgical management in our semi-urban African setting; while also reviewing the available literature on the subject to possibly validate our practice. Patients and methods: All patients with penile fracture managed in our university teaching hospital between January 2014 and December 2015 were prospectively studied in order to identify any peculiarities of clinical presentation, surgical reconstruction technique and management outcome. Results: Six male patients were studied. Their ages ranged from 23 to 41 years (mean 31 years) while interval between penile fracture occurrence and clinical presentation in our emergency unit ranged from 45 min to 30 h (mean about 10 h). The aetiologic mechanism was penile self manipulation (2, 33.2%), masturbation (1, 16.7%), sexual intercourse with the female in the dominant position (1, 16.7%), turning in bed (1, 16.7%) and motorcycle road traffic accident in a man with local aphrodisiac induced penile erection who was rushing home to his female partner (1, 16.7%). The rupture of the tunica albuginea was located on the right side in majority of cases (4, 66.7%) while none of the patients had coexisting urethral injury. All of them had surgical repair between 3 and 9 h of presentation with good cosmetic and functional outcome. Conclusion: The trend of penile fracture seems to be changing in our semi-urban African community. Surgical reconstruction results in good outcome. Keywords: Penile fracture, Ruptured corpus cavernosa, Disrupted tunica albuginea, Nigeria