Management of traumatic rupture of the corpora cavernosa
Ouanes, Y1; Ben Rhouma, S1; Chaker, K1; Sellami, A1; Nouira, Y1
1: La Rabta University Hospital, Tunisia
Objectives: The fracture of penis is a rare urological emergency which requires a prompt management in order to prevent late complications. We aim to study the epidemiological, clinical and therapeutic characteristics of penile fracture as well as the patients sexuality outcome after treatment.
Material and methods: It is about a retrospective study including 73 patients who underwent surgery for fracture of penis from January 2000 to December 2016. Detailed history and clincal findings, the delay of time between fracture and management, as well as modalities of treatment were documented for each case. Postoperative erectile function outcomes were assessed with the International Index of Erectile Function (IIEF-5), and the presence of postoperative penile curvature was noted.
Results: The median age of the patients was 32,6 years (interquartile range [IQR]: 19 - 50 years). 42 patients were married. The most common causes were forced manipulation of the erect penis while masturbating in 40 cases (55%) and blunt trauma during sexual intercourse in 28 cases (39%). The delay time between the fracture and consultation ranged from 1 hour to 5 days. 53 patients had presented less than 24 hours after the trauma. The symptoms reported were severe sharp pain, an expansive hematoma and penile deformity in all cases. In majority of cases (85%) the surgical approach was electively over the area of suspected fracture. The median length of tunica albuginea defect was 15 mm. Only one patient presented with Fournier gangrene immediately after surgery. Postoperative IIEF-5 scores were 21 and 23 at the first and third postoperative months, respectively. Meanwhile, 3 patients developed penile curvature, only one patient complained of sexual dysfunction and underwent a successful surgical treatment.
Conclusion: The diagnosis of penile fracture includes detailed history and clinical examination. No paraclinical investigations are necessary. A normal sexuality is only insured by an early management in order to avoid late complications.
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