Management of penile fracture

ABSTRACT

To document the clinical presentations, diagnostic methods and therapeutic approach for the patients presenting with penile fracture and out comes of the treatment. Prospective observational study Surgical 'C' and 'B' Ward of Khyber Teaching Hospital Peshawar, Pakistan, from January 2001 to December 2004. 17 patients presenting with fracture of the penis during this period were included in the study after approval from the Hospital Ethics' Committee. Age, marital status, activity leading to the injury, symptoms and signs, management and outcome were recorded on a proforma designed for the purpose. The common age group was 30-50 years with 13 [76.47%] patients in this group, 14 were married and 3 were students. Eleven [64.70%] cases of fractures occurred during sexual intercourse and 6 cases due to non-coital causes including masturbation and manipulation. Fifteen patients recalled a popping sound, immediate detumescence and deviation were present in all, penile swelling and hematoma in 15 while the tunical defect was easily felt in 2 patients. Diagnosis was made clinically and was confirmed on surgical exploration. Repair of tunical defect was done with vicryle 2/0. No urethral injury was encountered. Out come was excellent and all patients regained complete penile function at 3 months follow up. Mild penile curvature was seen in 5 patients but it did not interfere with erection or sexual activity. Penile fracture is an entity with typical clinical signs and no further investigations is usually needed. Management is surgical and immediate to avoid complications related to erectile dysfunction