After 12 months of follow-up, the mean IEEF-5 score was 22. There was no significant postoperative morbidity except for two patients who had mild wound infection. Urethral repair was required in 13 cases (13.4%). The mean tear length was 16.5 mm (range = 7–37 mm). All tears were unilateral and on the ventral aspect of the penis. On surgical exploration, a tunical tear was found in the proximal shaft of the penis in 118 patients (85.5%) and in distal part in 20 patients (14.5%). Two different incisions were used: elective incision was performed in 112 patients (81.2%) while circumferential degloving incision was used in other cases whenever it was impossible to locate the tunical tear by physical examination. Spinal anesthesia was used for all patients. Decision of surgery was only based on clinical findings (history and physical examination). The mean surgery delay was 14.3 hours (range = 3-18 hours). Penile swelling and/or ecchymosis was present in all patients mostly involving the whole penis associated in four cases with scrotal swelling. Snap sound was heard by all patients except nine. By history, all patients had no problems with erectile function before penile fracture, only three patients had risk factors for systemic vascular diseases at first presentation, such as diabetes mellitus (two patients) and hypertension (one patient). The most common cause of penile fracture in our patients was forcefully bending of the erect penis to achieve detumescence in 44.9% of cases followed by maneuvers during sexual intercourse in 34%. The presentation delay varied from 1 hour to 5 days (mean = 16.8 hours). The aim of our study was to identify the factors that may influence the sexual function after surgical repair.Ī total of 138 patients were operated for penile fracture in our department with a mean age of 31.2 years (range 19-55). 6 It has been reported that the incidence of ED after surgical repair of fracture penis ranges from 0% up to 12%. 7, 8 ED seems to be the most critical problem because of the serious physical and psychological consequences that may have on the patient. 1, 8 Serious complications such as penile curvature, erectile dysfunction (ED), development of plaques or urethral fistulas may develop due to inappropriate and/or late surgical repair. 6, 7 According to many recent studies, immediate surgical repair should be performed in order to have more adequate functional and cosmetic results. 4, 5 A loud snapping sound is usually heard by the patient associated with sharp penile pain and rapid detumescence. 1, 2, 3 The incidence of penile fractures is underreported because many patients do not seek medical attention due to the embarrassment of being seen with this unusual injury. All rights reserved.Penile fracture is a traumatic rupture of the tunica albuginea of the corpus cavernosum secondary to blunt trauma to the erect penis with subsequent subcutaneous hematoma with or without rupture of the corpus spongiosum and the urethra. Seven patients (28%) had penile curvature and one patient underwent penile plication surgery.Īfter PF repair, age is the only risk factor for ED and penile curvature rarely requires surgical treatment.Ĭirugía Curvatura de pene Disfunción eréctil Erectile dysfunction Fractura de pene Penile curvature Penile fracture Surgery.Ĭopyright © 2022 Asociación Española de Andrología, Medicina Sexual y Reproductiva. The IIEF-5 scores correlated with age (p=0.009, r=0.510). With a multivariate analysis, age was independently associated with ED (p=0.048, odds ratio=1.104, 95% confidence interval 1.000-1.218). With a univariate analysis, age and penile curvature were significantly associated with ED (p=0.008 and p=0.039, respectively). Among these patients, 9 patients (36%) had mild ED and 4 patients (16%) had moderate ED. At the final follow up, erectile dysfunction (ED) was present in 13 patients (52%). Two of the patients had concomitant urethral injury. The median age of patients at the time of surgery and the median follow-up duration were 46 years (22-60 years) and 95 months (12-156 months), respectively. All patients filled out the International Index of Erectile Function (IIEF-5) form and penile curvature was examined. All patients underwent immediate PF repair. PF was diagnosed by examining patients' medical histories and performing physical examinations. To determine the factors that cause erectile dysfunction and penile curvature after repair of penile fracture (PF).ĭata from 25 patients who underwent PF repair was retrospectively analyzed.
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