Fracture of the Penis: A Review

Abstract

Fracture of the penis is not uncommon and usually occurs during intercourse when the erect penis forcefully hits against the perineum or symphysis pubis. The aetiology varies with geographical area, and additionally penile self-manipulation is more common in the Middle East. While imaging may be used as an adjunct to aid diagnosis, especially in equivocal cases, it remains largely a clinical diagnosis. Immediate repair has been established as the standard of care although delayed repair has also been employed with equally successful outcomes. The degloving incision facilitates very good exposure but repair may be undertaken via a simple direct incision if the fracture site can be localised. Urethral injuries usually require repair, although successful non-operative management of small partial tears has been described. Postoperative medications to suppress erections have not been of proven benefit.

Conservative management of penile fracture: a case report

“…Due to the hematoma's mass effect, the penis may shift to the opposite side. 3 Blood at the meatus, difficulty voiding, or gross or microscopic hematuria may be signs of urethral damage, but their absence does not rule it out. 2 This patient had no ecchymosis, eggplant appearance, or full bladder.…”

“…The underlying clot above the fracture site may be felt as a little swelling that can be covered by rolling the penile skin, producing the "rolling sign. " Due to the hematoma's mass effect, the penis may shift to the opposite side 3. Blood at the meatus, difficulty voiding, or gross or microscopic hematuria may be signs of urethral damage, but their absence does not rule it out 2.…”