Immediate Surgical Intervention for Penile Fracture: a Case Report and Literature Review

PENILE fracture is a critical urological emergency, which is caused by the rupture of the tunica albuginea of the corpus cavernosum following blunt trauma to the erect penis. Traumatic injuries of the penis often occur in the erected state.1 Due to the possible embarrassment, this condition has been under- reported. Typically, the patient reports a snap or cracking sound accompanied by sharp pain and rapid penile detu- mescence, followed by immediate development of swelling and angulation.2 The common causes include direct injuries, forceful masturbation, or vigorous sexual intercourse.3 Most injuries to the penis need immediate surgical treatment. Here we report a case of penile fracture caused by traumatic injury.

Penile Fracture—Report on Three Cases from Cape Coast, Ghana

Introduction: Penile fracture is a urological emergency that occurs when the penis in an erect state suffers a blunt trauma resulting in a rupture of the tunica albuginea of either one or both corpora cavernosa. It is often caused by vigorous sexual intercourse, hence the incidence of penile fracture is under-reported. We therefore present our experience of the clinical presentation and surgical management of penile fracture. Presentation of Cases: We report three cases of penile fracture and all were diagnosed based on their clinical presentation and examination findings. The patients include two middle aged men and one young man, all with history of hearing a popping sound and experiencing sudden onset pain with detumescence of the penis. No radiological investigations were carried out. An emergency surgical repair was done for all patients. Discussion: All the patients had no urethral injury on presentation and underwent immediate surgical repair. The erectile and voiding function of each patient was preserved. Conclusion: The management of penile fracture involves early diagnosis and immediate surgical repair. Early intervention is necessary to preserve penile function.

Penile mass formation after neglected penile fracture:Surgical management with pericardial graft reinforcement

Background:Penile fracture is defined as the rupture of the tunica albuginea of the corpora cavernosa while in an erect state,during mostly intercourse or masturbation.Diagnosis of such condition is mainly clinical,while on the other hand,seeking medical attention is often delayed,and treatment options depend upon the time of presentation.Methods:This case report details a patient who developed a penile cystic fibro-hematoma lesion,2 months after a neglected penile fracture.After proper assessment including detailed history,physical exam and a penile doppler ultrasound,patient was elected for surgery.Results:The patient underwent surgical removal of the mass,correction of the curvature,and reinforcement of the weakened tunica albuginea with a pericardium graft.Postoperative course was uneventful.At follow-up,he reported normal erectile function with resolved penile curvature.Conclusion:This highlights the importance of seeking prompt medical attention for suspected penile fractures to avoid potential long-term complications.

Risk factors for penile fracture compared with a surgical control cohort in the United States: the role of substance abuse

Penile fracture(PF)is a surgical emergency.Given its rarity,we queried a national cohort over an 11-year period to study the temporal and demographic variations in presentation,evaluation,and management of patients with PF compared with a cohort of control patients.The National Inpatient Sample was queried between the years 2005 and 2016 for patients with a diagnosis of PF.Appendectomy patients were selected as a control cohort,given the non-discriminatory nature of this disease.Clinical and demographic data of the patients were compared with that of controls.Presenting symptoms,rates of surgical repair,and rates of associated surgical procedures were evaluated in the PF cohort.During the study period,5802 patients were hospitalized for PF.The annual incidence of PF remained unchanged at 1.0-1.8 cases per 100000 hospitalizations over the study period.Compared with the control cohort,PF patients were more likely to be younger(38.7 years vs 41.2 years,P≤0.001),have lower rates of comorbidities except erectile dysfunction(1.4%vs 0.1%,P≤0.001),and were more likely of Black race(25.4%vs 6.2%,P≤0.001).Notably,PF patients had significantly higher rates of substance abuse(26.4%vs 18.1%,P≤0.001),despite no difference in the diagnosed psychiatric disorders.PF rarely presented with hematuria(3.5%);however,urethral evaluation was performed in 23.1%,most commonly with cystoscopy(19.2%).PF occurs more commonly in a younger,healthier male population,and among minorities.Importantly,rates of substance abuse appear to be higher in the PF cohort compared with those of controls.

Isolated penile urethral injury:A rare case following male coital trauma

Penile fractures are an uncommon urological emergency.Typically,penile fractures involve the corpus cavernosum and are sometimes associated with urethral injury.Isolated corpus spongiosum and urethral injuries without concomitant corpus cavernosum injury are,however,rare.With proper knowledge of the management of penile fractures and urethral injuries,this distinct entity can be diagnosed,assessed and managed successfully without complications.

Retrospective and Prospective Study on Injuries during Coital Accidents at the Central Hospital of Yaounnde: A Study of 23 Cases

Introduction: A penile fracture is the traumatic rupture of the turnica albuginea of one of both cavernous bodies of an erect penis. It is a urologic emergency in young adults. The objective of our study is to determine the epidemiologic, clinical, and therapeutic aspects and evaluate the complications at the Yaounde Central Hospital (YCH). Methodology: It was a cross-sectional retrospective and descriptive study, carried out for a period of five years, from 2015 to 2020, followed by a prospective phase for a period of 1 year, from December 2020 to 2021 at the Urology Unit of Yaounde Central Hospital. Results: Our study involved 23 patients. The mean age was 34 ± 4 years with extremes of 23 - 65 years. Married men were the most involved, with 16 cases (69.6%). The majority of patients presented for consultation within the first 6 hours (60.9%). The mean delay time before the consultation was 5 [3 - 24] hours, with extreme values of 1 - 72 hours. Sitting position during sexual intercourse was mainly found (56.5% of cases), while alcohol consumption was the main environmental risk factor found (47.8% of cases). Penile pain (100.0%) and deformation of the penile shaft (91.3%) were the most encountered symptom during admission. The frequency of cavernosa involement was 87.0%. The injury was partial in the majority of cases (95.0%), involving both corpus cavernosa (55.0%) and mostly on the right (60.0%). The mean management delay was 5 hours standard deviation [5 - 7], with extremes of 2 - 48 hours. The intra-cavernous hematoma was the essential per-operative finding in all the operated cases (100.0%). Most patients resumed sexual intercourse 2 - 3 months following management (65.3% of cases). After one year of treatment, 78.3% of patients declared satisfactory sexual activity. Conclusion: Penile fracture is an anthological emergency in young adults. The management is essentially surgical. Functional prognosis depends on the promptitude of surgical intervention.