Penile fracture: long-term outcome of treatment.

OBJECTIVE: Penile fracture is a rare injury, usually resulting from direct trauma to the erect penis during sexual intercourse. Immediate surgical treatment is the basis for the treatment of this injury due to the high rate of complications associated with delayed management. The aim of this study was to evaluate the clinical presentations, diagnostic methods, and outcomes of the treatment.

MATERIAL AND METHOD: We retrospectively studied patients with penile fracture treated at Ramathibodi Hospital from 1975 to 2000. Clinical presentation, diagnostic methods, technique of treatment and outcomes of treatment were noted.

RESULTS: Twelve patients were found in this study. The mean patient age was 32 years old (range 19-42). The interval from time of injury to presentation was 3-48 hours. Of these patients 10 had been injured during sexual intercourse (83%) while 2 had been injured during masturbation. All patients presented with a very suggestive clinical picture (pain, detumescence and hematoma). No further investigation was needed for confirming the diagnosis. One case had urethral bleeding, therefore, retrograde urethrogahpy was performed but no extravasation of contrast media was noted. All patients were treated by immediate surgery, through a circular subcoronal incision and degloving of the penis to allow a thorough exploration. All of the patients had a tunica albuginea tear that was promptly repaired. No associated urethral larceration was noted. All of the patients did very well after surgery and two had mild curvature, which had not hindered intercourse at follow-up (mean time of 24 months).

CONCLUSIONS: Penile fracture has very typical clinical signs and no further investigation is usually needed. Early surgical treatment is associated with a low incidence of late complications.