Abstract
Penile fracture is a rare urological occurrence resulting from a tear in the tunica albuginea of the penis. In this study, 26 patients diagnosed with a penile fracture were treated with early surgical correction. The mean age at the time of the injury was 41.7 years. The average follow-up time of the study population was 28.8 months. The mean time from fracture to surgery was 15.6 ± 19.9 h. In total, 23% of the patients had a penile nodule and 11.5% of these patients reported penile deviation. Post surgery, erectile dysfunction (ED) was present in nine (34.6%) patients. During the follow-up, the mean International Index of Erectile Function (IIEF-5) score was 20.9 ± 4.3 (10–25). There was no significant difference in the time from fracture to surgery among the patients with or without ED. However, the tunical tear size was significantly larger in the patients with ED as compared with those without ED. Furthermore, the patients with ED were older than those without ED. Older age and the size of the tunical tear appeared to be correlated with the development of ED. However, prospective large series are needed to confirm these results.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 8 print issues and online access
$259.00 per year
only $32.38 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
References
McEleny K, Ramsden P, Pickard R. Penile fracture. Nat Clin Pr Urol. 2006;3:170–4.
Summers A. Penile fracture. Emerg Nurse. 2007;15:18–9.
Zargooshi J. Penile fracture in Kermanshah, Iran: report of 172 cases. J Urol. 2000;164:364–6.
Bali RS, Rashid A, Mushtaque M, Nabi S, Thakur SA, Bhat RA. Penile fracture: experience from a third world country. Adv Urol. 2013;2013:708362.
Metzler IS, Reed-Maldonado AB, Lue TF. Suspected penile fracture: to operate or not to operate? Transl Androl Urol. 2017;6:981–6.
Barros R, Schulze L, Ornellas AA, Koifman L, Favorito LA. Relationship between sexual position and severity of penile fracture. Int J Impot Res. 2017;29:207–9.
Falcone M, Garaffa G, Castiglione F, Ralph DJ. Current Management of penile fracture: an up-to-date systematic review. Sex Med Rev. 2018;6:253–60.
Pariser JJ, Pearce SM, Patel SG, Bales GT. National patterns of urethral evaluation and risk factors for urethral injury in patients with penile fracture. Urology. 2015;86:181–5.
Gupta N, Goyal P, Sharma K, Bansal I, Gupta S, Li S, et al. Penile fracture: role of ultrasound. Transl Androl Urol. 2017;6:580–4.
Ahmadnia H, Younesi Rostami M, Kamalati A, Imani MM. Penile fracture and its treatment: is retrograde urethrograghy necessary for management of penile fracture? Chin J Traumatol. 2014;17:338–40.
Yapanoglu T, Aksoy Y, Adanur S, Kabadayi B, Ozturk G, Ozbey I. Seventeen years' experience of penile fracture: conservative vs. surgical treatment. J Sex Med. 2009;6:2058–63.
Muentener M, Suter S, Hauri D, Sulser T. Long-term experience with surgical and conservative treatment of penile fracture. J Urol. 2004;172:576–9.
Yamacake KG, Tavares A, Padovani GP, Guglielmetti GB, Cury J, Srougi M. Long-term treatment outcomes between surgical correction and conservative management for penile fracture: retrospective analysis. Korean J Urol. 2013;54:472–6.
Kamdar C, Mooppan UM, Kim H, Gulmi FA. Penile fracture: preoperative evaluation and surgical technique for optimal patient outcome. BJU Int. 2008;102:1640–4. discussion 4
Rees RW, Brown G, Dorkin T, Lucky M, Pearcy R, Shabbir M, et al. British Association of Urological Surgeons (BAUS) consensus document for the management of male genital emergencies—penile fracture. BJU Int. 2018;122:26–8.
Bolat MS, Ozen M, Onem K, Acikgoz A, Asci R. Effects of penile fracture and its surgical treatment on psychosocial and sexual function. Int J Impot Res. 2017;29:244–9.
Rosen RC, Cappelleri JC, Smith MD, Lipsky J, Pena BM. Development and evaluation of an abridged, 5-item version of the International Index of Erectile Function (IIEF-5) as a diagnostic tool for erectile dysfunction. Int J Impot Res. 1999;11:319–26.
Turunç T, Deveci S, Güvel S, Peşkircioğlu L. The assessment of Turkish validation with 5 question version of International Index of Erectile Function (IIEF-5). Turk J Urol. 2007;33:45–9.
Rosen RC, Riley A, Wagner G, Osterloh IH, Kirkpatrick J, Mishra A. The international index of erectile function (IIEF): a multidimensional scale for assessment of erectile dysfunction. Urology. 1997;49:822–30.
Reis LO, Cartapatti M, Marmiroli R, de Oliveira EJ,Jr, Saade RD, Fregonesi A. Mechanisms predisposing penile fracture and long-term outcomes on erectile and voiding functions. Adv Urol. 2014;2014:768158
Shindel AW, Brandt WO, Bochinski D, Bella AJ, Lue TF. Medical and surgical therapy of erectile dysfunction. In: De Groot LJ, Chrousos G, Dungan K, Feingold KR, Grossman A, Hershman JM, et al., editors. Endotext. South Dartmouth (MA); 2000.
Mirzazadeh M, Fallahkarkan M, Hosseini J. Penile fracture epidemiology, diagnosis and management in Iran: a narrative review. Transl Androl Urol. 2017;6:158–66.
De Luca F, Garaffa G, Falcone M, Raheem A, Zacharakis E, Shabbir M, et al. Functional outcomes following immediate repair of penile fracture: a tertiary referral centre experience with 76 consecutive patients. Scand J Urol. 2017;51:170–5.
Zargooshi J. Sexual function and tunica albuginea wound healing following penile fracture: an 18-year follow-up study of 352 patients from Kermanshah, Iran. J Sex Med. 2009;6:1141–50.
Penbegul N, Bez Y, Atar M, Bozkurt Y, Sancaktutar AA, Soylemez H, et al. No evidence of depression, anxiety, and sexual dysfunction following penile fracture. Int J Impot Res. 2012;24:26–30.
Kozacioglu Z, Ceylan Y, Aydogdu O, Bolat D, Gunlusoy B, Minareci S. An update of penile fractures: long-term significance of the number of hours elapsed till surgical repair on long-term outcomes. Turk J Urol. 2017;43:25–9.
Beysel M, Tekin A, Gurdal M, Yucebas E, Sengor F. Evaluation and treatment of penile fractures: accuracy of clinical diagnosis and the value of corpus cavernosography. Urology. 2002;60:492–6.
Turkay R, Yenice MG, Aksoy S, Seker G, Sahin S, Inci E, et al. Contribution of MRI to clinically equivocal penile fracture cases. Turkish. J Trauma Emerg Surg. 2016;22:549–52.
Maurice MJ, Spirnak JP. The impracticality of MRI for the diagnosis of atypical penile fracture in the emergency setting. Emerg Med J. 2014;31:421–2.
Unnikrishnan R, Goel R, Thupili C, Rackley R. Ultrasound of acute penile fracture. J Urol. 2013;190:2253–4.
Zare Mehrjardi M, Darabi M, Bagheri SM, Kamali K, Bijan B. The role of ultrasound (US) and magnetic resonance imaging (MRI) in penile fracture mapping for modified surgical repair. Int Urol Nephrol. 2017;49:937–45.
Hatzichristodoulou G, Dorstewitz A, Gschwend JE, Herkommer K, Zantl N. Surgical management of penile fracture and long-term outcome on erectile function and voiding. J Sex Med. 2013;10:1424–30.
Zargooshi J. Penile fracture in Kermanshah, Iran: the long-term results of surgical treatment. BJU Int. 2002;89:890–4.
Penson DF, Seftel AD, Krane RJ, Frohrib D, Goldstein I. The hemodynamic pathophysiology of impotence following blunt trauma to the erect penis. J Urol. 1992;148:1171–80.
Munarriz RM, Yan QR, ZNehra A, Udelson D, Goldstein I. Blunt trauma: the pathophysiology of hemodynamic injury leading to erectile dysfunction. J Urol. 1995;153:1831–40.
Tsao CW, Lee SS, Meng E, Wu ST, Chuang FP, Yu DS, et al. Penile blunt trauma induced veno-occlusive erectile dysfunction. Arch Androl. 2004;50:151–4.
Wong NC, Dason S, Bansal RK, Davies TO, Braga LH. Can it wait? A systematic review of immediate vs. delayed surgical repair of penile fractures. Can Urol Assoc J. 2017;11:53–60.
Bozzini G, Albersen M, Otero JR, Margreiter M, Cruz EG, Mueller A, et al. Delaying surgical treatment of penile fracture results in poor functional outcomes: results from a large retrospective multicenter European study. Eur Urol Focus. 2018;4:106–10.
el-Assmy A, el-Tholoth HS, Mohsen T, Ibrahiem el HI. Does timing of presentation of penile fracture affect outcome of surgical intervention? Urology. 2011;77:1388–91.
Saglam E, Tarhan F, Hamarat MB, Can U, Coskun A, Camur E, et al. Efficacy of magnetic resonance imaging for diagnosis of penile fracture: a controlled study. Invest Clin Urol. 2017;58:255–60.
Feldman HA, Goldstein I, Hatzichristou DG, Krane RJ, McKinlay JB. Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study. J Urol. 1994;151:54–61.
Echeverri Tirado LC, Ferrer JE, Herrera AM. Aging and erectile dysfunction. Sex Med Rev. 2016;4:63–73.
Author contributions
MO, FÖ, and ÖM contributed to the conception and design of the study. AE, MS, and UC acquired the data. MO, FÖ, and MS drafted the paper. MO and ÖM revised it for intellectual content. All authors read and approved the final paper.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Additional information
Publisher’s note: Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Ortac, M., Özgor, F., Caglar, U. et al. Older age and a large tunical tear may be predictors of increased erectile dysfunction rates following penile fracture surgery. Int J Impot Res 32, 226–231 (2020). https://doi.org/10.1038/s41443-019-0159-2
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/s41443-019-0159-2
This article is cited by
-
Erectile dysfunction and Peyronie’s disease diagnosis rates after penile fracture—a retrospective claims database cohort analysis
International Journal of Impotence Research (2024)
-
Role of penile rehabilitation through daily intake of 5 mg tadalafil on erectile dysfunction after different presentations of penile fracture: a prospective case–control study
International Urology and Nephrology (2023)
-
Conservative management of suspected fractures in men undergoing collagenase clostridium histolyticum for Peyronie’s Disease is not associated with worsening of erectile function
International Journal of Impotence Research (2022)