Which is guilty in self-induced penile fractures: marital status, culture or geographic region? A case series and literature review

Abstract

Penile fracture is a well-recognized and relatively uncommon clinical entity. It was previously reported that the incidence of penile fracture varies according to various geographic regions. In order to determine whether marital status or culture other than geographic region is involved in the etiology of penile fracture in our country, the charts of 122 men diagnosed with penile fracture were retrospectively reviewed. Detailed history including cause, symptoms, country of origin and a single-question self-report of erectile dysfunction was used for all cases. Diagnosis of our cases was mainly based on history and physical examination and ultrasonography. Immediate or delayed surgical repair of penile fracture included a degloving circumferential, and an additional direct incision, if the site of the tear could not be reached via degloving, was performed. The patients were evaluated after 1 week and 1, 3, and 6 months follow-up by penile examination, recording complications, and with a single-question self-report questionnaire after 3 and 6 months. The most common cause of penile fracture was manual bending of the erected penis in 66 out of 122 (54.1%) of our study patients. In our study, we believe that the prime causes of bending the penis are single status and culture, which are influencing factors irrespective of the geographic distribution.

Penile Fracture-Report of Two Cases and Review of Current Literature

“…11 The predisposing factor to concomitant urethral injury in penile fracture is not clear but it is postulated to be due to a more vigorous force applied during coitus compared with the prolonged but lesser force involved in masturbation. 11,13 Penile fracture may present with classic "eggplant deformity"of swollen penis along with ecchymosis confined to Buck's fascia . 11 The patient usually describe a cracking or popping sound during injury as tunica tears, followed by pain, rapid detumescence, discoloration and swelling of penile shaft.…”

“…Another causes are turning over in bed, a direct blow or forceful bending of the penis.In Nigeria reported causes of fracture are masturbation, stuttering priapism, vigorous sexual intercourse, turning in bed, forceful bending in the erect penis by the locally made bamboo bed. 13 The recent finding indicates that penile fracture appears to be in those population who use sexual exciting drugs before sexual intercourse. The case reported above was having coitus with wife using sexual stimulant drugs and another was masturbation.Treatment may be either conservative or surgical.…”

Penile Fracture Diagnosis and Management- A North Indian Tertiary Care Experience

“…Penile fractures most commonly reported during sexual intercourse sometimes may occur during masturbation. (7) A fracture occurs during vigorous sexual intercourse, especially when semi-rigid penis slips out of the vagina and hitting perineum or pubic bone, producing a buckling injury. Other mechanisms of injury are rolling over the erect penis, falling on the erect penis and selfmanipulation (practice of Taqaandan) The main presenting features are penile swelling, detumescence, urinary difficulty, hematuria, penile pain, etc.…”

1124 The Egydio geometrical procedure for managing penile curvature using a single relaxing incision: A single-centre experience with 330 patients

“…phosphodiesterase-5 inhibitors and pentoxifylline) can be applicable in the early phase, but simultaneous corporal reconstruction procedures with concomitant implantation of a penile prosthesis should be performed in severe cases of corporal fibrosis [15]. Also, penile fibrosis after pelvic fracture or self-induced penile fractures results in severe ED [16,17]. Of course, penile prosthesis surgery is an integral part of the treatment of severe ED when non-surgical options fail or are contraindicated [18].…”