Penile trauma management in absence of fracture: Long-term outcomes

This study evaluates the clinical outcomes of patients with suspected penile fractures who were managed conservatively after MRI excluded tunica albuginea rupture or fracture.

A retrospective review was conducted over a seven-year period, identifying patients who presented with symptoms suggestive of penile fracture. All patients who underwent MRI imaging to confirm or exclude the presence of a tunica albuginea rupture. Based on MRI findings, patients without confirmed fractures were managed conservatively, including instructions to avoid sexual activity and strenuous physical exertion. Follow-up assessments were conducted to monitor long-term complications, with a specific focus on erectile function, assessed via the International Index of Erectile Function (IIEF) and penile curvature.

Of the 30 patients with suspected penile fractures, MRI excluded fractures in 63%. Among these conservatively managed patients, approximately 60% developed erectile dysfunction (ED) and 27% developed penile curvature. Even in cases without confirmed fractures, patients with contusions demonstrated significant post-injury complications.

MRI is effective in ruling out penile fractures, supporting the use of conservative management when fractures are not confirmed. However, conservative treatment alone is associated with a notable rate of complications, suggesting the potential benefit of early penile rehabilitation to address functional outcomes in these patients.