Penile Fracture: Long-term Outcome of Immediate Surgical Intervention
Received 27 July 2009; accepted 26 August 2009. published online 06 November 2009.
Objectives
To assess the etiology and the late effects of penile fractures treated by immediate surgical intervention.
Methods
Between 1986 and 2008, a total of 155 patients with penile fracture were treated surgically in our center. The interval from injury to presentation was between 1 and 96 hours. Those patients were contacted by mail or phone and were re-evaluated. All patients were re-evaluated by questionnaire and local examination. Patients with erectile dysfunction were evaluated by color Doppler ultrasonography.
Results
The most common cause of fracture of penis is sexual intercourse (51.5%). Unilateral and bilateral corporeal ruptures were present in 139 (89.7%) and 3 (1.9%) cases, respectively, whereas no tunical tear was found in 13 (8.4%) cases. Concomitant urethral injury was present in 14 (9%) cases. Long-term follow-up (>12 months) was available for 141 patients; among whom there was no complications in 108 (77%), painful erection in 2 (1.3%), penile deviation in 5 (3.2%), both in 1 (0.7%), erectile dysfunction in 11 (7.8%), and palpable scaring in 14 (10%). Scar formation was highly associated using nonabsorbable sutures (P <.001).
Conclusions
Vigorous sexual intercourse was found to be the most common cause of penile fracture. Immediate surgical intervention has low morbidity, short hospital stay, rapid functional recovery, and no serious long-term sequelae. Nonabsorbable sutures should be avoided as it has a higher incidence of scar formation.
Department of Urology, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
Reprint requests: Ahmed El-Assmy, M.D., Urology and Nephrology Center, Mansoura, Egypt
ABSTRACT