Traumatic Injury of the Penis: Surgical Management

Abstract

Three cases of penile injury secondary to mishap during sexual intercourse are described. The injury involved unilateral corpus cavernosum associated with urethral rupture in one case, penile fracture in the second patient and isolated urethral fracture in the third. Diagnosis and treatment of these uncommon lesions are discussed.

Penile fracture: Retrospective analysis of our case history with long-term assessment of the erectile and sexological outcome

“…Urethral bleeding (25), hematuria and voiding difficulties (3,24) indeed indicate urethral rupture, however the absence of these signs and symptoms does not exclude possible urethral involvement (3,5,43,48). In medical literature, there have been reports of urethral laceration even in the absence of a rupture of the corpora cavernosa (13,49). The clinical presentation in these cases of isolated urethral injury differs from typical penile fractures for the absence of noise, penile deformity and for the absence of palpable penile defects (49).…”

“…The most frequent causes of penile lesion are related to the geographical areas considered. In Western countries the most common cause is sexual intercourse (6,(12)(13)(14), particularly vigorous, with the penis stroking the bony structures of the pelvis, in 30-50% of cases (6). In Middle Eastern countries and in North Africa (8,9,(15)(16)(17)(18) fractures are almost always due to handling or masturbation, as a custom widespread in these regions, called "Taqaandan", a maneuver which consists of bending upwards, downwards or sideways, suddenly and vigorously, a part of the penis in erection, keeping the other part in place, to facilitate the detumescence (8,9).…”

Fractured Penis: Diagnosis and Management (CME)

“…In the Western hemisphere, it is most commonly secondary to trauma encountered during vigorous sexual intercourse when the penis slips out of the vagina, hitting the perineum or the pubic symphysis [10,19]. This mechanism of injury represents 30–50% of reported cases [33]. Certain sexual practices and positions, such as the female superior position, provides an increased risk of fracture, possibly due to abnormal angulation of the erect penis when pushed against the female perineum or pubic symphysis [34].…”

Body piercing

“…15 Management of urethral tears typically involves evaluation by retrograde urethrography. 65 A partial tear may be converted to a complete transection by the inadvertent introduction of a catheter. Partial tears may require a suprapubic cystotomy and primary repair.…”

“…Partial tears may require a suprapubic cystotomy and primary repair. 65 Embedded jewelry is another complication reported with piercing. 6,[66][67][68][69][70][71][72] Typically this has been associated with the use of an ear-piercing gun.…”