Analysis on diagnosis and treatment of penile fractures in single clinical center in recent 25 years / 中华创伤杂志

ABSTRACT

Objective To summarize the epidemiological features,diagnosis and treatment of the penile fractures in single clinical center in recent 25 years so as to improve the treatment level.Methods A retrospective case series study was conducted on 23 patients with penile fractures from January 1993 to June 2017.The average age of patients was 37.78 years (range,21-66 years).Nineteen patients were married and four were not.Fourteen patients had penile fractures in summer,five in winter,three in spring and one in autumn.Three patients had Bachelor's degree or above,while 20 had less than university education.There were nine urban and 14 rural residents.Nineteen patients were caused by violent intercourse,two by violent masturbation,one by oral sex and one without willing explanation.All patients were unilateral rupture of albuginea penis,including five with urethral rupture.No misdiagnosis or missed diagnosis occurred.The time from injury to surgery was average 32 h (1993-2002),10.5 h (2003-2012),and 3.8 h (2013-2017),respectively.Emergency operations were performed using the degloved distal foreskin to repair the albuginea penis.The penile erectile function,urination and complications were recorded.Results All patients were followed up for 6-62 months (mean,26 months).In all patients,morning erection was restored at days 1 to 3 after operation,and normal urination was attained after the removal of urethral catheter.Normal sexual life was restored within 3 months after the operation.Penis elephantiasis combined with poor postoperative skin healing was seen in one patient,and mild penile erection pain was reported by one patient.No obvious erectile dysfunction,abnormal urination or other severe complications were reported.Conclusions The epidemiological features of penile fractures include low incidence,relatively concentrated region and age of onset,diversity of causes,and patients with insufficient education.Penile fractures can be diagnosed based on medical history and body examination.Emergency surgery is the first choice for penile fracture,with satisfactory outcomes and few postoperative complications.