C H Chung1, Y K Szeto, K K Lai. 1. Accident and Emergency Department, North District Hospital, Sheung Shui, Hong Kong. chunch@ha.org.hk
Abstract
OBJECTIVES: To examine the epidemiology of penile 'fracture' and its presenting characteristics in the local population. DESIGN: Retrospective study. SETTING: District hospital, Hong Kong. PATIENTS: Patients with a discharge diagnosis of 'fractured' penis during a 7-year period from August 1998 to August 2005. MAIN OUTCOME MEASURES: Age, time of attendance, cause, symptoms, signs, emergency department diagnosis, site of rupture, operative findings, and final outcome. RESULTS: A total of 11 patients were identified. The mean age was 44 years (range, 30-63 years). The interval between time of injury and presentation ranged from 17 minutes to 7 days. Seven (64%) cases were attributed to sexual intercourse, three (27%) to penile manipulation, and one (9%) to rolling over the erect penis during sleep. Ten patients underwent surgery; all had primary suturing of the tunica tear, while two also required primary urethral repair. At follow-up, three (27%) patients had erectile dysfunction, one had mild penile deformity and one had a mild urethral stricture. CONCLUSION: Emergency physicians and surgeons, as well as family physicians, should be familiar with the presentation of 'fractured' penis, as prompt diagnosis and early surgical repair are instrumental in ensuring a successful outcome with minimal complications. The public should also be educated to seek medical attention immediately, as delay or failure to report may result in permanent physical and psychological disabilities that could otherwise have been avoided.
OBJECTIVES: To examine the epidemiology of penile 'fracture' and its presenting characteristics in the local population. DESIGN: Retrospective study. SETTING: District hospital, Hong Kong. PATIENTS: Patients with a discharge diagnosis of 'fractured' penis during a 7-year period from August 1998 to August 2005. MAIN OUTCOME MEASURES: Age, time of attendance, cause, symptoms, signs, emergency department diagnosis, site of rupture, operative findings, and final outcome. RESULTS: A total of 11 patients were identified. The mean age was 44 years (range, 30-63 years). The interval between time of injury and presentation ranged from 17 minutes to 7 days. Seven (64%) cases were attributed to sexual intercourse, three (27%) to penile manipulation, and one (9%) to rolling over the erect penis during sleep. Ten patients underwent surgery; all had primary suturing of the tunica tear, while two also required primary urethral repair. At follow-up, three (27%) patients had erectile dysfunction, one had mild penile deformity and one had a mild urethral stricture. CONCLUSION: Emergency physicians and surgeons, as well as family physicians, should be familiar with the presentation of 'fractured' penis, as prompt diagnosis and early surgical repair are instrumental in ensuring a successful outcome with minimal complications. The public should also be educated to seek medical attention immediately, as delay or failure to report may result in permanent physical and psychological disabilities that could otherwise have been avoided.
Authors: Juan Gómez Rivas; Jose Maria Alonso Dorrego; Mario Martín Hernández; Pamela Fontana Portella; Sonia Pérez González; Jose Antonio Moreno Valle; Jesús Javier de la Peña Barthel Journal: Cent European J Urol Date: 2014-04-17