Penile fracture: evaluation, therapeutic approches and outcome result. single surgeon experience

ABSTRACT

The experience of a single surgeon with a series of23 penile fractures, including 21 corrected surgically and 2 managed conservatively, in 3 year period is presented .Standard diagnostic and therapeutic modalities are described. Between December 2004 and October 2007, 23 patients 19 to 58 years old [mean age 38] were evaluated in Assiut university hospital after blunt trauma to the erect penis. The interval from injury to presentation was between 2 and 72 hours. Of these patients, 18 had been injured during sexual intercourse, 3 had been injured during manual detumescence, and 2 due to rolling over in bed. Sonography and MRJ were used for diagnosis in all patients. Surgery in 21, involved a subcoronal incision and degloving in 15 patients and inguinal scrotal incision in 6 patients. 2 patients were treated conservatively after diagnosed by MRJ as deep dorsal vein rupture. Injury involved unilateral and bilateral corporeal rupture in 18 and 3 cases, respectively, and urethral injury in 4. At follow up, all patients [23] reported normal erection and voiding. Mild glanular parathesia on erection and numbness were experienced in 2 patients explored by subcoronal incision and degloving. This study confirmed the overall superiority of immediate surgical repair. MRI is a good and reliable tool for diagnosis of fracture penis and affects the mode of freatment whether conservative or surgical. Scrotal inguinal incision as a method of exploration in fracture penis is effective and reliable as well as subcoronal incision and degloving