Effects of penile fracture and its surgical treatment on psychosocial and sexual function

Bolat, Mustafa Suat; Özen, Mehmet; Önem, Kadir; Açıkgöz, Aydan; Aşçı, Ramazan

doi:10.1038/ijir.2017.31

Cited by 13 publications

(8 citation statements)

References 32 publications

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“…Sexual activity is important for the quality of men's life and may be affected by penile trauma via psychological factors [14]. Boncher et al [15] reported that there was a loss of selfconfidence leading to anxiety and depression in penile fracture patients and their partners during their early follow-up.…”

Section: Discussionmentioning

confidence: 99%

The effect of a penile fracture on ejaculatory and erectile functions: A cross-sectional study

Can¹,

Merder²,

Canat³

et al. 2021

Journal of Surgery and Medicine

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Section: Discussionmentioning

confidence: 99%

The effect of a penile fracture on ejaculatory and erectile functions: A cross-sectional study

Can¹,

Merder²,

Canat³

et al. 2021

Journal of Surgery and Medicine

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“…In our cases, there were only four patients (11.1%) with an incomplete urethral disruption where urethral anastomosis of the tear was needed. Many studies reported that an immediate surgical repair provides better long-term outcomes than conservative treatments 12,14. Muentener et al15, observed that the success rate was 92% for immediate surgical treatment and 59% for conservative management.…”

Section: Discussionmentioning

confidence: 99%

“…Yapanoglu et al16, and Gamal et al17, also reported similar results, and found that a prompt surgical treatment improved outcome, rather than conservative treatment. The conservative management of PF has been linked to penile curvature greater than 60° in more than 20% of the patients, debilitating plaques in 25–30% of the patients, and significantly longer hospitalization times 14,15,17. However, postoperative unsatisfactory penile curvatures are frequent in the literature.…”

Section: Discussionmentioning

confidence: 99%

<p>Simultaneous curvature correction at the time of the penile fracture repair: surgical and functional outcomes</p>

Dell’Atti

Scarcella

Tallè

et al. 2019

RRU

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Purpose: After a penile fracture (PF), an early surgical exploration and defect closure of the lesions are recommended to prevent long-term complications. However, postoperative unsatisfactory penile curvatures are frequent in the literature. In this study, we wished to present surgical outcomes of PF after surgical repair approach with an early intraoperative curvature correction and update our series with postoperative follow-up. Patients and methods: An institutional retrospective review study of 36 patients undergoing surgical treatment for PF was performed. Mean age of patients was 53.2 years. All surgical explorations were performed within 12 hours after the traumatic event. The surgical repair with a contemporary penile plication was then made to straighten the tunica angulations in patients with curvature greater than 30°, using 2– 3 pairs of 2–0 absorbable suture of polydioxanone. Results: The length of the tear ranged from 8 to 20 mm. 77.7% of the patients required a correction of the cavernous body deviation. No early complications occurred in any case. The median patient stays in the hospital was 3.4 days. At a mean follow-up of 20.6 months, all patients were able to insert the penis in the partner’s vagina, and were satisfied overall with sexual intercourse; three patients (10.7%) reported residual pain and discomfort for the knots of the sutures. Conclusions: An early intraoperative curvature correction may be used for a variety of angulation deformities and severe degrees of deviations secondary to a repair after penile trauma, and may be helpful in preventing postoperative morbidity.

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“…tance -likely associated with the already documented negative long-term psychological impact of the disease (8). Such modifications in sexual behavior, while detrimental to the patient's and partner's quality-of-life, may subliminally pro-tect the patient against another frature.…”

Section: Article Infomentioning

confidence: 99%

Editorial Comment: Lessons learned after 20 years' experience with penile fracture

Filho

Ribeiro

2020

Int. braz j urol.

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The article describes the authors' 20-year experience with penile fracture, gained from their work at largest emergency department of the city of Rio de Janeiro (1). This study follows previous publications on the subject of penile fracture by the same group of authors (2-4), and provides the practising urologist with valuable information about the diagnosis and treatment of the disease. Although there is justifiable debate about whether one should surgically approach penile fractures through a subcoronal (the authors'-and ours'-choice), penoescrotal or perineal incision, the attending urologist must first determine whether the patient has, in fact, a penile fracture, or a vascular injury mimicking a penile fracture, i.e. a false penile fracture (5-7). The authors' no-nonsense approach to this diagnostic problem was to consider patients that did not describe immediate detumescence after injury, presenting small-to-moderate penile hematoma (or none at all) and without abnormalities in the palpation of the corpora cavernosa as having a lower likelihood of penile fracture-and offer to these patients supplemental imaging studies or conservative treatment with close follow-up. The reader must be cautioned, however, that such line of action is grounded by the authors' large experience, and that the default approach in clinically diagnosed penile fracture patients is surgical exploration. Another facet of the authors' large experience with the disease can be observed in their approach to synchronous urethral injuries, diagnosed in 54 of their patients (18.7%). Preoperative retrograde urethrography (RUG) was performed in a little less than half of those (25/54, 47%), and their logic in restricting the indication of RUG is simple to follow: Urethral injuries are not rare in penile fracture; RUG has been associated with high false-negative rates (reference 14 in the article); penile degloving provides excellent exposure to the penile urethra; urethral repair can be easily performed concomitant with tunical repair; ergo, one can forgo RUG in these cases. Yet, one should not promptly waive RUG if the surgical plan involves an incision directly to the site of injury, even more so if there is any sign of urethral injury, e.g. urethral bleeding, urinary retention. Our last comment addresses the fact that the study included 285 patients and 288 penile fractures, as 3 patients had a recurrent fracture-at the same site as the first one. This finding calls to attention that changes in the biomechanical properties of the tunica albuginea at the site of injury predosposes the organ to repeat fracture. The last consideration regards the patient's behavior during the sexual act. Since the persistence of the sexual behavior that caused the fracture may lead to a recurrent fracture, one can conjecture that the sparseness of recurrent fractures may stem from modifications in sexual behavior-decreases in the frequency of intercourse, avoidance of certain positions, for ins

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Effects of penile fracture and its surgical treatment on psychosocial and sexual function

Cited by 13 publications

References 32 publications

The effect of a penile fracture on ejaculatory and erectile functions: A cross-sectional study

The effect of a penile fracture on ejaculatory and erectile functions: A cross-sectional study

<p>Simultaneous curvature correction at the time of the penile fracture repair: surgical and functional outcomes</p>

Editorial Comment: Lessons learned after 20 years' experience with penile fracture

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