A diagnosis of penile fracture specifically refers to the rupture of the corprora cavernosa, one of the two erectile tissues found in the penis. The other erectile tissue is called the corpora spongiosum, which contains the urethra. Thus, the urethra may also be injured in more severe cases.
Penile fracture usually occurs when blunt force trauma causes an erect penis to bend forcibly and extremely. This may cause the rupturing of the tunica albuginea, which is the tough fibrous layer that covers the penis. It may also injure either one or both of the erectile tissues within it. Injury to the urethra is seen mostly in cases that involve the rupturing of both corpora.
Incidence of penile fracture is hard to determine given that it is often underreported in most parts of the world. Majority of its causes, however, can be attributed to coital injuries that usually occur when an erect penis is thrusted on to the female’s pelvis area. The female dominant position, wherein the woman is on top and the penis slips out underneath her, is the most commonly reported. Other causes are acrobatic sexual positions, aggressive masturbation and penile manipulation.
Signs and Symptoms of Penile Fracture
Penile fracture often presents with severe acute pain. A popping or breaking sound may also be heard at the moment of injury. Other signs and symptoms are as follows:
- Rapid detumescence, or softening, of the penis
- Swelling in the area around the injury
- Bruising of the penis as blood leaks out the ruptured soft tissues
- Abnormal curvature of the penis, often becomes S shaped
- If urethra is also injured, blood may be seen at the opening tip of the penis and may produce urine admixed with blood
- Dysuria or painful urination may also be experienced
Diagnosis of penile fracture is often made based on these findings during a physical examination and history of the patient.
Treatment of Penile Fracture
Penile fracture is considered to be a urologic emergency that necessitates prompt surgical exploration and repair wherein the ruptured tissues are put back together. If surgical therapy is delayed, the following may be done:
- Cold compress over the penis
- Pressure dressing
- Pain medications
- Non-steroidal Anti-inflammatory medications to reduce the swelling
Patients may also need to undergo a procedure that makes use of the Urethrogram in order to check if the urethra is intact or is also injured.
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Long-term Complications of Penile Fracture
Immediate surgical intervention has been shown to reduce long-term complications of penile fracture. However, the following can still develop after the surgical operation:
- Abnormal shape of the penis as it deviates to one side
- Painful erection
- Painful intercourse
- Erectile dysfunction
- Priapism or the condition wherein the penis does not return to its flaccid state after an erection
- Necrosis of the skin in the area of the penis
- Urethral stricture or narrowing of the urethra
Penile fracture is a painful condition that results from the traumatic rupturing of the penis due to a blunt force trauma usually while the penis is erect.