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Lessons learned after 20 years' experience with penile fracture
Rodrigo Barros1, Daniel Hampl1, Andre Guilherme Cavalcanti2
1Serviço de Urologia, Hospital Municipal de Souza Aguiar, Rio de Janeiro, RJ, Brasil.
Summary
Penile fracture (PF) is typically diagnosed clinically, with sexual trauma being the most common cause. Surgical treatment yields satisfactory results, though complications like erectile dysfunction can occur.
Area of Science:
- Urology
- Trauma Surgery
Background:
- Penile fracture (PF) is a rare but serious condition resulting from trauma to the penis.
- Understanding the etiology, clinical presentation, and surgical outcomes of PF is crucial for effective patient management.
Purpose of the Study:
- To report the 20-year experience in the diagnosis and surgical treatment of penile fracture.
- To analyze the etiological factors, clinical findings, and postoperative outcomes.
Main Methods:
- Retrospective review of patients diagnosed with PF between January 1997 and January 2017.
- Assessment of medical records for clinical presentation, etiology, operative findings, and postoperative complications.
- Evaluation of sexual and urinary function post-surgery.
Main Results:
- Sexual trauma accounted for 88.5% of PF cases, with specific sexual positions linked to higher injury severity.
- Hematoma and immediate detumescence were the most common clinical presentations.
- Corpus cavernosum injuries occurred in 69% (unilateral) and 31% (bilateral) of patients; urethral injuries were present in 18.7%.
Conclusions:
- PF typically presents with characteristic clinical signs, often negating the need for further diagnostic tests.
- While surgical reconstruction offers satisfactory outcomes, potential complications include erectile dysfunction and penile curvature.
- Concomitant urethral injury must be considered in high-energy trauma cases.