Management and outcomes of penile fracture: a ten year multicentric study
Kara, N1; Morel Journel, N1; Badet, L2; Ruffion, A1; Terrier, JE1
1: Hopital Lyon Sud, France; 2: Hopital Edouard Herriot . Lyon
Objectives: Penile fracture is a rare surgical emergency which requires prompt diagnosis and surgical repair.
In a 10 year period, we reviewed the clinical, radiological and pre-operative presentations of operated penile fractures. We assess the erectile and satisfactory long-term outcomes depending on the surgical approaches.
Materials & Methods: It was a multicentric retrospective study from 2005 to 2016. The patients included had a penile fracture confirmed during the surgical exploration. Depending on the availability, a penile ultrasonography or MRI was performed in case of diagnosis doubts. The surgical treatment consisted of a coronal or elective incision with the research of urethral lesion and a corporal repair. The patients presenting a dorsal vein rupture or a hematoma without penile fracture were excluded. The erectile function and the satisfaction were evaluated through the IIEF and the EDITS questionnaires.
Results: 47 consecutive patients were included with an average of 42.5 (22-69) years of age. The average care delay was 1.46 days (3h-7d) while the average delay of hospitalization was 2.3 days. A cracking sound was audible in 62% of the cases, a rapid detumescence and an urethrorrhagia were described in respectively in 67% and 14.7% of the cases. A penile ultrasound was performed in 56.9% of the cases enabling a 51% fracture localization rate. In 13.4% of the cases we found a bilateral fracture, and an urethral injury in 10.15%. The average length of cavernous corpus fracture was 1.75 cm (0.5-3 cm). Two revision surgeries were performed for a persistent urethrorrhagia and for a phimosis. 11 patients presented a penile curvature, all less than 30°. No difference was found for penile curvature and IIEF scores between the coronal or elective incision. More than 85% of the patients were satisfied with the esthetic and the sexual activity results. The average IIEF score was 24.2
Conclusions: Low incidence of postoperative complications and good satisfactory functional outcomes are reported when early repair is performed.Although operator dependent, ultrasonography is a useful tool in confirming the location of the albuginea tear. No difference are found for penile curvature and IIEF scores between the coronal or elective incision, those results need to be confirmed by a prospective randomized study .
Work supported by industry: no.Go Back