Functional outcomes following immediate repair of penile fracture: a tertiary referral centre experience with 76 consecutive patients

Luca, Francesco De; Garaffa, Giulio; Falcone, Marco; Raheem, Amr Abdel; Zacharakis, Evangelos; Shabbir, Majed; Aljubran, Abdelkareem; Muneer, Asıf; Holden, Fiona; Akers, C.; Christopher, Nim; Ralph, David

doi:10.1080/21681805.2017.1280532

Cited by 41 publications

(37 citation statements)

References 30 publications

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“…PF is one of the urological emergencies; however, its true incidence is unclear since patients are often hesitant to report to a health facility. 2–6 According to the literature, the most common cause of PF is sexual intercourse (33%–60%), a finding confirmed by our study. 7,8 The diagnosis of PF is primarily based on clinical features.…”

Section: Discussionsupporting

confidence: 85%

“…(Figure 1) Physical examination and medical history may be inaccurate in 15% of patients with suspected PF. 3 The “eggplant” presentation is typical, with a purple and bulging penis appearing upon physical examination. In most cases, the diagnosis is clinical, but in doubtful situations, ultrasonography examination can help diagnose the condition by showing the location and extent of tunica albuginea disruption.…”

Section: Introductionmentioning

confidence: 99%

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Penile fracture and investigation of early surgical repair effects on erectile dysfunction

et al. 2019

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Objectives: Penile fracture is one of the urological emergencies caused by direct trauma to an erect penis during sexual intercourse, which results in a tear in the tunica albuginea within the corpus cavernosum. Serious complications such as penile curvature and erectile dysfunction may develop due to inappropriate and/or late surgical repair. This study aims to evaluate patients with penile fracture and to describe their demographics, surgical repairs, and long-term outcomes. Materials and Methods: A total of 56 patients who were diagnosed with penile fracture between January 2012 and June 2017 were reviewed. Clinical features, pre-operative assessment, time from injury to surgery, tunica defect properties, and presence of urethral injury were assessed. Early surgical management was performed. Outcomes, including International Index of Erectile Function 5 pre-operation and after 6 months, were evaluated. Results: The mean age was 30.2 (18–57) years. In etiological questionnaires, 32 (57.2%) patients reported direct trauma to an erect penis during intercourse. The mean size of tunica defects was 1.61 ± 0.42 (0.3–3.6) cm of the nine (16%) patients, and penile fracture was associated with urethral injury. There was no significant difference in International Index of Erectile Function 5 scores before the surgery and 6 months after surgery. Penile skin necrosis developed in one patient 10 days post-operation. Conclusion: Early surgical repair could be an effective method of achieving post-operative erection success in patients with penile fracture due to direct trauma during intercourse.

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Section: Discussionsupporting

confidence: 85%

Section: Introductionmentioning

confidence: 99%

Penile fracture and investigation of early surgical repair effects on erectile dysfunction

et al. 2019

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“…Under spinal anaesthesia, the surgical approach most commonly used is circumcoronal incision, penile degloving with inspection of whole corpora and spongiosa to avoid any missed injury [10]. But with advent of imaging which can pinpoint the defect, targeted incision could be planned to avoid complete degloving [11]. Non absorbable suture is avoided for repair as it remains palpable post operatively.…”

Section: Discussionmentioning

confidence: 99%

Unexplained Recurrent Nocturnal Urethral Bleeding: An Unusual Presentation of Penile Fracture

Arya¹

2020

AUN

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Penile fracture is an emergency urological condition defined as rupture of tunica albuginea of corpora cavernosa because of trauma to erect penis as a result of sudden increase in intra-corporeal pressure. Typically it occurs during coitus when the phallus strikes against the pubis or perineum of partner producing a buckling injury [1]. It can also occur during self-manipulation, rolling over or falling onto erect penis or due to practice of "taqaandan" [2,3].Patient usually describes a "cracking" or "popping" sound followed by detumescence, pain, swelling and discoloration of penile shaft.If the Buck's fascia remains intact the hematoma is limited to shaft.If it is also disrupted the hematoma can reach to perineum and suprapubic area. Diagnosis is clinical and management is primarily surgical. We report our experience of managing penile fracture cases over last 6 years with especial impression upon a group of patients having an unusual clinical presentation with unexplained recurrent nocturnal urethral bleeding without penile swelling. Materials and MethodsThis is a retrospective analytical study of cases of penile fracture treated at our institution from August 2014 to September 2019. Patients with penile fracture with diagnosis based on

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“…The pain and sound are made by a strain in the tunica albuginea that during erection become thin from 2 to 0.25-0.50 mm. reducing its elasticity and reaching, in case of rupture, an internal pressure of 1.500 mmHg (2). The lesions of tunica albuginea could be unilateral or bilateral involving the corpus spongiosum of the urethra (3,4).…”

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confidence: 99%

Diagnosis and treatment of penile injury: ten years experience of an emergency department

Panella

Pepe

Pennisi

2020

Arch Ital Urol Androl

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Introduction: To evaluate the imaging accuracy in the diagnosis and clinical management of penile injury.Materials and methods: From January 2010 to January 2020, 20 men (median age 40.2 years) were admitted to our Emergency Department with the diagnosis of penile injury; the penile trauma was related to sexual intercourse in 16 cases, masturbation in 3 cases and injury caused by the partner in 1 case. All the patients underwent accurate medical history, clinical examinations and diagnostic imaging. Color Doppler ultrasound (CDU) evaluation was performed by Logiq E9 ecograph (General Electric; Milwaukee, WI) supplied with a linear probe small (7.5-10 MHz); magnetic resonance image (MRI) examination was performed within 3-24 hours from the trauma using a 1.5 Tesla scanner, (ACHIEVA 3T; Philips Healthcare Best, the Netherlands) performing pre-contrast and post-contrast multi-planar turbo spin-echo T1 and T2-weighted sequences. Results: 15/20 (75%) men with high suspicion of the tunica albuginea rupture underwent surgical exploration; conversely, 5/20 (25%) patients underwent conservative management. CDU detected 11/15 (73%) fractures of the penis and in 8 of them the length of the rupture was underestimated (more than 5 millimeters). On the contrary, MRI diagnosed all the albuginea ruptures showed by surgical exploration, but underestimated the length of the lesions in 9/15 (60%) cases. The IIEF-5 score administered six months later penile trauma demonstrated a good performance in all the patients. Conclusions: In our series, all the patients with a tunica albuginea rupture < 5 mm. diagnosed by MRI were submitted to conservative management with a complete functional restitutio ad integrum.

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Functional outcomes following immediate repair of penile fracture: a tertiary referral centre experience with 76 consecutive patients

Abstract: Penile fracture is a rare urological emergency and requires early surgical exploration and repair. Ultrasonography is a cheap and readily available investigation that allows confirmation of the diagnosis, and identification of the location of the tear and the associated urethral injury.

Cited by 41 publications

References 30 publications

Penile fracture and investigation of early surgical repair effects on erectile dysfunction

Penile fracture and investigation of early surgical repair effects on erectile dysfunction

Unexplained Recurrent Nocturnal Urethral Bleeding: An Unusual Presentation of Penile Fracture

Diagnosis and treatment of penile injury: ten years experience of an emergency department

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