Review of management of penile fractures at a single institution

Abstract

Objectives:

Penile fracture is rare. Optimal surgical management remains uncertain.

Patient and Methods:

A retrospective cohort analysis of patients with penile fracture between 2004–2017 was conducted using an institutional database. Patient demographics, etiology of injury, presentation, fracture location, surgical incision used, presence of concomitant urethral injury, and post‐operative complications were analysed.

Results:

Eight patients were eligible. Mean age was 46.8 years. Six reported coital‐related causes. Two had penile fractures secondary to penile‐manipulation and “accidental fall”. Two patients had associated visible haematuria.

All underwent emergency repair with penile‐degloving incisions. Seven had right‐sided corpus cavernosal injury. All patients had ventro‐lateral injury. Only one patient had fracture located in distal penis, caused by penile‐manipulation. Both patients with hematuria had urethral injury. Cystoscopy was only performed in 63% of patients.

Two patients reported subjective alteration of erectile function but were able to continue sexual intercourse. Four patients reported wound complications and unsatisfactory wound cosmesis.

Conclusion:

Degloving incision for the repair of penile fractures was often unnecessary as penile fractures are proximal especially if cause was coitus‐related. Such incision is associated with significant rate of wound‐related complications. A ventral inverted‐V incision may be more favourable. Routine investigations for urethral injury should be advocated.