Penile Fracture : Experience from a Tertiary Care Hospital

Abstract

Introduction: Penile fracture is a misnomer, penile fracture is defined as rupture of the tunica albuginea of one or both corpus cavernosum. The usual cause is abrupt bending of the erect penis by blunt trauma, which may occur during sexual intercourse, masturbation, rolling over on the bed, or falling onto the erect penis. Diagnosis of penile fracture is made on the basis of history and physical examination. the standard model of management is surgical.Methods: This retrospective study was conducted in the department of surgery SMHS hospital Srinagar,(Jammu and Kashmir), extending over a period of about three and a half years from June 2013 to January 2017. All patients with diagnosed penile fracture were included in this study. All except one patient were operated on the same day of admission.Results: out of a total of 50 patients studied, the mean age of presentation was 26.7 years. The majority (56%)were below 30 years of age.21 (42%) of the patients were married.majority42% of the patients reported masturbation as a cause of trauma, followed by vaginal intercourse in38% and rolling on the erect penis in 20%. About 80% of patients gave a history of audible click/crackling sound. All patients had swelling and discoloration on examination,90% of patients had a penile deformity, only 36 % had a palpable defect. Doppler USG was correct in 93% of patients. The majority (44%) of patients had defects less than 1cm. the defect was mostly seen on the right side (68%).most patients had proximal penile defect (56%). Mean hospital stay was 2.9 days. One patient (2%) had urethral trauma.Surgery had a recurrence of 2%.and a total postoperative complication rate of 10%.Conclusions: Penile fracture though reported rarely, is a common entity. Penile fracture is a urological emergency.Diagnosis is mainly on clinical grounds.Immediate surgical repair is the standard treatment of a penile fracture.