Risk factors for penile fracture compared with a surgical control cohort in the United States: the role of substance abuse / 亚洲男科学杂志(英文版)

Penile fracture (PF) is a surgical emergency. Given its rarity, we queried a national cohort over an 11-year period to study the temporal and demographic variations in presentation, evaluation, and management of patients with PF compared with a cohort of control patients. The National Inpatient Sample was queried between the years 2005 and 2016 for patients with a diagnosis of PF. Appendectomy patients were selected as a control cohort, given the non-discriminatory nature of this disease. Clinical and demographic data of the patients were compared with that of controls. Presenting symptoms, rates of surgical repair, and rates of associated surgical procedures were evaluated in the PF cohort. During the study period, 5802 patients were hospitalized for PF. The annual incidence of PF remained unchanged at 1.0-1.8 cases per 100 000 hospitalizations over the study period. Compared with the control cohort, PF patients were more likely to be younger (38.7 years vs 41.2 years, P ≤ 0.001), have lower rates of comorbidities except erectile dysfunction (1.4% vs 0.1%, P ≤ 0.001), and were more likely of Black race (25.4% vs 6.2%, P ≤ 0.001). Notably, PF patients had significantly higher rates of substance abuse (26.4% vs 18.1%, P ≤ 0.001), despite no difference in the diagnosed psychiatric disorders. PF rarely presented with hematuria (3.5%); however, urethral evaluation was performed in 23.1%, most commonly with cystoscopy (19.2%). PF occurs more commonly in a younger, healthier male population, and among minorities. Importantly, rates of substance abuse appear to be higher in the PF cohort compared with those of controls.

Penile Fracture with Rupture of Bilateral Corpora Cavernosa and its Management by Emergency Surgeon

Introduction: Penile fracture is rarely encountered by theemergency surgeon. It is defined as the rupture of the tunicaalbuginea of the corpus cavernosum due to a blunt traumaon an erect penis. Usually one corporal body undergoes atransverse tunical rupture but involvement of both corporacavernosa, corpus spongiosum and urethra have also beenreported.Case report: The authors report a case of penile fracture in a38 years old male patient which was managed by an emergencysurgeon. The diagnosis was reached on the basis of clinicalpresentation. We also highlight the etiology, the process ofdiagnosis, the surgical repair and prognosis of penile fracture.Conclusion: Early repair has the best prognosis. As a urologistmay not be available at all emergency centers, an emergencysurgeon should be well versed with it.

Clinical effect observation of small incision for repairing penile fracture under ultrasound guidance / 重庆医学

Objective To explore the clinical effect of color Doppler ultrasound guided small incision in repairing penile fracture.Methods Sixteen cases of penile fracture single cavernosum rupture adopted the preoperative positioning by color Doppler ultrasound,hematoma removal and albuginea repair.The clinical effect was evaluated after operation.Results The albuginea rupture was smoothly found in 15 cases,1 case was converted to coronary sulcus annular degloving incision.The operation time was 20-60 min with a mean of 35 min;the postoperative hospital stay was 3.0-6.0 d with a mean of 4.8 d;the catheter removal was on postoperative 3-5 d,urination was unobstructed.Follow up lasted for 6-12 months,1 case appeared transient erectile dysfunction,the harden was touched during erection in 1 case,and other cases had no obvious complication occurrence.Conclusion The color Doppler ultrasound can locate the rupture of corpora cavernosa penis and albuginea.Selecting color Doppler ultrasound guided small incision in repairing penile fracture has small trauma and less complications,and can get satisfactory effect.

Fracturas del pene / Penile fracture

Background: Penile fracture occurs when the erect penis is bent suddenly and forcefully, rupturing the tunica albuginea of one or both of the corpus cavernosum. A delay in its treatment may lead to functional and morphological sequelae. Case reports: We report five patients aged 26 to 44 years with penile fracture and right corpus cavernosum involvement. All patients excepting one had felt pain. An emergency ultrasound was done in three cases to confirm the diagnosis and the extension of the lesion. All were operated, had an uneventful postoperative period and are currently asymptomatic.

Introducción: La fractura del cuerpo cavernoso representa una urgencia urológica infrecuente pero grave, ya que la lesión de estructuras cercanas y una demora en su tratamiento suele generar complicaciones morfológicas y funcionales irreversibles. Casos clínicos: Registramos 5 casos de fractura peneana en nuestro hospital en el período 2008-2012, con afectación del cuerpo cavernoso derecho y hematoma asociado en todos ellos. La edad promedio fue de 33,5 (rango 26-44) años. Todos relataron los síntomas característicos excepto uno, que permaneció sin dolor. Se realizó una ecografía urgente en 3 casos para confirmar el diagnóstico y evaluar la extensión de la lesión. Los pacientes fueron intervenidos quirúrgicamente de urgencia, el postoperatorio transcurrió sin incidencias y actualmente todos se encuentran asintomáticos.

Ultrasound evaluation of penile fractures

This short case report discusses the various aspects of penile fracture, which is a rare entity. Nevertheless, the incidence of penile fractures is on the rise due to the increased use of performance-enhancing drugs. An individual with a penile fracture should seek immediate medical referral. Prompt diagnosis and management is necessary to prevent undesirable after-effects as discussed. Emphasis is made on how imaging with ultrasound enables a quick and complete assessment of this mishap.

Risk Factors for Development of Long-term Complications after Surgical Repair of Penile Fracture / 대한남성과학회지

PURPOSE: The aim of this study was to review clinical features of penile fracture and to characterize risk factors for the development of long-term complications after its surgical correction. MATERIALS AND METHODS: We retrospectively reviewed the cases of 10 patients who underwent surgical therapy for penile fracture between June 1995 and September 2003. Patient age at presentation ranged from 17 to 54 years (mean 32 years). All patients underwent surgical therapy in an emergency setting. The time between the injury and surgery ranged from 7 to 240 hours (mean 44.5 hours). Radiologic work-up included penile ultrasonography for 9 patients and retrograde urethrography for patients suspected of having concomitant urethral injury. We investigated multiple clinical features to characterize risk factors relevant to the development of long-term complications. The mean follow-up was 36.5 month. RESULTS: Penile ultrasonography revealed defects in the tunica albuginea in seven patients, including six in whom the defect was identical to the injury site. At surgery, the size of the injury was between 3 mm and 50 mm. Two patients with concomitant urethral injury showed larger defects than those with an intact urethra. Long-term complications such as penile curvature and erectile dysfunction were found in two men with large defects involving the urethra and three with long lapses from injury to surgical correction. CONCLUSIONS: Long-term complications after surgical therapy for penile fracture are likely to occur in patients with a large defect in the tunica albuginea involving the urethra or with delayed surgical correction.

Penile Fracture: A Report of 4 Cases / 대한비뇨기과학회지

Traumatic rupture of the corpus cavernosum of the penis is rare and has been reported infrequently. We experienced 4 cases of penile fracture for recent 2 years. They occurred during coitus(1 case), masturbation(2 cases), and through blunt trauma(1 case). The former 3 cases were treated with immediate surgical intervention about 12 hours after injury. When the last case patient visited hospital 5 days after injury, the penile abscess treated immediately with surgical intervention had developed. Surgery consisted of complete evacuation of the hematoma or pus and repairing of the tear at the tunica albuginea. The results were excellent, with complete early recovery of erectile function. Delayed wound healing was observed only in a patient who underwent surgery about 5 days after injury, but this did not cause any complication afterward. In our experiences, immediate surgical treatment is recommended in patients with fracture of the penis.

Penile Injury During Erection: The Clinical Manifestations and Results of Operative Treatment / 대한비뇨기과학회지

This study was designed to evaluate the clinical manifestations and results of operative treatment in penile injury during erection. We reviewed 18 cases of penile injury during erection from December 1992 to June 1996. Of 18 patients, 14 patients were treated with early operation, 3 patients with conservative treatment and followup was 1 to 31 months (mean: 14.1 months). Patients age ranged from 23-76 years old (mean: 39.6 years), common cause of the injury was sexual intercourse (8 cases), masturbation (3 cases) and finger-pressure (2 cases) in order. Of 8 patients who occurred during sexual intercourse, 7 patients were married. The injury developed at midnight in 8 cases (44%), early morning in 7 cases (39%) and the other times in 3 cases (~7%). Of 14 patients who received with early operation, 13 patients revealed rapture of the corpus cavernosum and 1 patient revealed rupture of superficial dorsal vein. The site of penile fracture showed proximal shaft in 8 cases (62%), midshaft in 3 cases (23%) and distal shaft in 2 cases (15%) in order. The overall complication rate of early operative treatment was 15% (2 of 13 cases) compared to a complication rate of 100% (2 of 2 cases) for conservative treatment. In conclusion, our experience demonstrates that the most common cause and site of penile injury are sexual intercourse and proximal shaft, early operative treatment would be an effective treatment of penile injury to prevent complications.

Fracture of the penis: results of early surgical treatment / 대한비뇨기과학회지

Rupture of the corpus cavernosum, commonly referred to as penile fracture, is an unusual urologic emergency. Nine patients were treated surgically among ten patients with fracture of the penis between January 1987 and February 1991. Follow up was obtained in nine. During follow up they were achieving normal, painless erections or normal marital relations. One patient developed a slight penile curvature but this did not affect his sexual activity. In view of these good results, including a short hospital stay, low morbidity and early return to full sexual activity, early surgical treatment is strongly recommended in patients with fracture of the penis.

Penile fracture: a report of 6 cases / 대한비뇨기과학회지

Penile fracture is an uncommon injury resulting from a direct blow to the erect penis. The authors experienced 6 cases of penile fracture recently and reviewed the literature. We performed immediate exploration with suture closure of the defect in all cases. None of the patients had penile deformity and all retained erectile potency. One of the two patients on whom primary end-to-end anastomosis was performed due to urethral rupture had mild urethral stricture. Therefore, we advocate early surgical repair of the penile fracture.

Penile fracture: a report of 6 cases / 대한비뇨기과학회지

Penile fracture is an uncommon injury resulting from a direct blow to the erect penis. The authors experienced 6 cases of penile fracture recently and reviewed the literature. We performed immediate exploration with suture closure of the defect in all cases. None of the patients had penile deformity and all retained erectile potency. One of the two patients on whom primary end-to-end anastomosis was performed due to urethral rupture had mild urethral stricture. Therefore, we advocate early surgical repair of the penile fracture.

Penile fracture: experiences with conservative and surgical treatment / 대한비뇨기과학회지

We experienced with 3 cases of penile fractures for recent 2 years, one occurred during masturbation and the others occurred during coitus(one case was associated with urethral injury). While the former was treated with conservative management, the latters were treated with surgical intervention that was immediate removal of hematoma and primary closure of ruptured corpus cavernosum. Penile deformity end decrease in rigidity occurred in conservatively treated case. However, two cases of immediate surgical treatment had a excellent result without complication. Even though we describe only 3 cases and could not compare the degree of injury. our short experiences suggest that immediate surgical intervention is better than conservative management in initial treatment of penile fracture.

Penile Fracture: 2 Cases / 대한비뇨기과학회지

Penile traumatic fracture is reported infrequently in the world. A review of the literature suggests that immediate surgical intervention is the treatment of choice. Herein we report on 2 cases with penile fracture, review the literature.

Penile Fracture: A Report of 2 cases / 대한비뇨기과학회지

Penile fracture is rather rare. Authors recently experienced two cases of penile fracture and reviewed the literature. Case 1 was an 18-year-old single male who visited our emergency room on 7th Dec, 1980 with the chief complaint of painful swelling and deformity of the penis. The present illness started with a cracking sound. An emergency operation was done. The Buck's fascia and the tunica albuginea of the left corpus cavernosum were torn transversely with hematoma formation. The hematoma was removed and the tom tunica albuginea and Buck's fascia were sutured. On the 6th post-operative day, he discharged with improved symptoms. Case 2 was a 35-year-old married male who visited our emergency room on 5th Dec, 1981 with the chief complaint of painful swelling and deformity of the penis. He also experienced a cracking sound. The corpus cavernography showed the tearing of the corpus cavernosum on the proximal dorsal penis. An emergency operation was done. The Back's fascia and the tunica albuginea of the right cavernosum were torn about 2 cm transversely. The tom albuginea and the Buck`s fascia were sutured with 4-0 Dexon. On the 11th post-operative day, he discharged without penile deformities.

A Case of Fracture of the Penis / 대한비뇨기과학회지

A case of fracture of the penis which had developed in a 57-year-old married male was presented with marked swelling and bending of the shaft of the penis due to hematoma formation. Evacuation of hematoma and suture of the reptured tunica albuginea resulted in good prognosis.

Fracture of Penis / 대한비뇨기과학회지

Fracture of the penis a rare condition, properly defined as a tear of the fibrous sheath of the corpora cavernosa occurred by direct blow or bending of the penis during erection. Its characteristic pathology is a tear in the tunica albuginea of the corpora cavernosa with hemorrhage, hematoma formation and distortion of the organ. Herein we reported a case of fracture of the penis, occurred by rolling in bed during erection in 26 years old man and repaired surgically.

Penile Fracture: Report of 2 Cases / 대한비뇨기과학회지

Penile fracture is rather rare. Authors experienced two cases of penile fracture recently and reviewed the literature. Case 1 is a 34-year-old married male who visited our clinic on 17th Sept, 1976 with the chief complaint of painful swelling and deformity of the penis. The present illness started with a cracking sound followed with chief complaint on the day before his visit by sudden change of posture. Conservative treatment was done. After treatment no curvature nor deformity of the penis was found. After discharge the patient lives normal sexual life. Case 2 is a 59-year-old married male who visited our clinic on 8th April, 1977 with the chief complaint of urethral bleeding, painful swelling and deformity of the penis. He also experienced a cracking sound. Urethral catheter will not pass forward and urethrogram revealed extravasation of dye in the pendulous portion. Urethroplasty and Foley catheter indwelling were done. Urethrocutaneous fistula happened but no curvature was noticed.