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Consequences of penile fracture: Complications and long-term functional outcomes
M R Peradejordi Font1, C Mercader Barrull1, J M López Martínez1
1Departamento de Urología, Hospital Clínic de Barcelona, Barcelona, Spain.
Insights
Penile fracture surgery generally yields good long-term sexual function. Urethral injury is more common when both corpora cavernosa are involved in the penile fracture.
Area of Science:
- Urology
- Surgical Outcomes
- Men's Health
Background:
- Penile fracture (PF) is a rare urological emergency.
- Long-term outcomes and complications following surgical repair are not well-documented.
Purpose of the Study:
- To evaluate postoperative complications and long-term functional outcomes in patients who underwent surgical repair for penile fracture.
- To identify risk factors for complications and assess functional sequelae.
Main Methods:
- Retrospective review of clinical records for patients undergoing urgent penile fracture surgery (2006-2020).
- Long-term functional outcomes assessed via telephone interviews (June 2020-February 2021).
- Evaluated lower urinary tract symptoms (IPSS), sexual function (EHS, IIEF-5), and morphological changes.
Main Results:
- 41 patients underwent penile fracture surgery; 11 had associated urethral injury (80% incidence with bilateral corpora cavernosa injury vs. 19.4%).
- Most complications were minor (Clavien-Dindo grade 1 or 2).
- Of 24 patients with long-term follow-up, 83.3% reported normal sexual function; 50% had palpable nodules, 33.3% new penile curvature, and 1 patient developed urethral stricture.
Conclusions:
- Surgical repair of penile fracture is associated with a high rate of good long-term sexual function.
- Bilateral corporal injury increases the risk of concurrent urethral injury.
- Long-term functional sequelae after surgical penile fracture repair are infrequent.
Introduction:
Penile fracture (PF) is a urological emergency with low incidence, and evidence of its long-term outcomes is scarce. This study focuses on postoperative complications and long-term functional outcomes in patients with PF and surgical repair at our center.
Materials And Method:
Clinical records of patients undergoing urgent surgery for PF at a third level hospital between 2006 and 2020 were retrospectively reviewed. Functional outcomes were assessed with voluntary telephone interviews from June 2020 to February 2021. Lower urinary tract symptoms were screened by IPSS questionnaire, sexual function by EHS and IIEF-5 and morphological alterations by direct questions to patients.
Results:
A total of 41 patients underwent surgery for PF. Eleven of them also had urethral injury (higher incidence if there was bilateral corpora cavernosa injury, 19.4% vs. 80%, p < 0.05). Only 1 patient presented a Clavien-Dindo type 3a complication due to wound dehiscence, 4 (13%) type 2 and 9 (29%) type 1. Twenty-four patients underwent long-term follow-up, of whom 20 (83.3%) presented normal sexual function. Twelve patients (50%) had a palpable nodule at the fracture site, 8 (33.3%) had new onset penile curvature and 1 patient with previous urethral injury presented urethral stricture.
Conclusion:
In cases of penile fracture, there is a higher incidence of urethral injury if both corpora cavernosa are affected. Long-term functional sequelae after surgical repair of a PF are rare.
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