Research Article

Penile fracturenot
not so rare
Venkat Arjunrao Gite1*, Anita Jagdish Kandi2
1, 2
Assistant Professor, Department of Surgery, Government Medical College, Aurangabad, Maharashtra, INDIA.
Email: balajigite@yahoo.com
Abstract Objective: To discuss the clinical presentation, etiology and management of fracture penis. Material Method: 15 cases
of fracture penis seen in department of surgery government medical college aurangabad between 2009 to 2014, all were
underwent emergency surgery after clinical examination and basic work-up. up. Surgery evolved an circumcoronal incision,
deglowing of penis and repair of tear. Result: Commonest age group roup between 30 to 40 years(10cases),out of 15 cases 11
were married and 4 were unmarried,9 cases presented within 6 hours,3 were between 6to 12 hours and rest 3 after 12
hour but before 2 days.8 cases had fracture as result of forceful coitus and 4 fall ffrom
rom bed / roll over on erect penis and 3
had during manipulation of erect penis.12 cases discharged between 7 to 10 days,2 cases on 7th days and one who had
associated urethral injury on 14th day. no one had postoperative complication, all patient had full erection except one
who need support in the form of medical treatment. Conclusion: Early arly presentation, Prompt surgical exploration and
repair are advocated in almost all cases, Immediate surgery reduces long-term
term complications.
Keywords: Penis fracture, corpus
orpus cavernosum, urethrography
urethrography.
*
Address for Correspondence:
Dr. Venkat Arjunrao Gite, Assistant Professor, Department of Surgery, Government Medical College, Aurangabad, Maharashtra, INDIA.
Email: balajigite@yahoo.com
Received Date: 02/03/2015 Revised Date: 10/03/2015 Accepted Date: 16/03/2015
physical examination
ination all had egg plant deformity
Access this article online suggestive of fracture penis (fig.1). urethrogaphy was
Quick Response Code: done in one case presented with blood at meatus. All
Website: cases promptly explored by circumferential deglowing
www.statperson.com incision (fig.2) and coporraphy done in all (fig.3) with
urethral
ethral repair in one case on catheter.

DOI: 18 March 2015 RESULT

INTRODUCTION
Although initially regarded as a relatively rare injury,
fracture of the penis is an increasingly reported
genitourinary trauma with associated urethral injury
ranges from 0% to 3% in Asia and the Middle East to
20% to 38% in the United States and Europe.1,2. Although
a majority of cases can be diagnosed from th the history and
physical examination alone, radiographic studies,
including retrograde urethrography and corporal
cavernosography can aid in the diagnosis of unusual
cases. Prompt surgical exploration and corporal and
urethral repair is the most efficacious therapy.3
MATERIAL METHOD
15 cases of fracture penis seen in department of surgery
government medical college Aurangabad between 2009
to 2014with typical presentation swelling, pain, and
penile deformity in all and blood at meatus in one. On
Commest
ommest age group between 30 to 40 years (10
cases).out of 15 cases 11 were married and 4 were
unmarried.9 cases presented within 6 hours,3 were
between 6to 12 hours and rest 3 after 12 hour but before 2
days. 8 cases had fracture as result of forceful coitus and
4 fall/rolling over bed on erect penis and 3 had during
manipulation of erect penis In all cases diagnosis was
made by clinical examination. All cases were explored
promptly after taking consent and explaining sequels of
fracture penis by circumferential deglowing incision. Out
of 15
5 , 8 had right corporal tear and 7 had on left side. 12
cases had tear at proximal corporal and 3 had at mid
corporal t area, blood clot at tear site (fig.4) with
associated 2/3 circumference urethral tear in one.
Operative time was less than 60 min. without
with need of
blood transfusion. perurethral catheter was placed for 24
hour in fourteen cases and two week in other case..12
cases discharged between 7 to 10 days, 2 cases on 7th
days and one who had associated urethral injury on 14 th
day.. All 15 patients were asymptomatic without any
chordee with adequate erection at 6 month follow. Tables

How to site this article: Venkat Arjunrao Gite,, Anita Jagdish Kandi
Kandi. Penile fracturenot so rare. MedPulse International Medical
Journal March 2015; 2(3): 126-128. http://www.medpulse.in (accessed 20 March 2015).
 MedPulse International Medical Journal, ISSN: 2348-2516, EISSN: 2348-1897, Volume 2, Issue 3, March 2015 pp 126-128

Table 1: Age wise distribution

Age <10yr 10-20 20-30 30-40 >40
No.pt - 3 2 10 -

Table 2: Time duration

Time <6hr 6-12 hr 12-24hr >24hr 1-2dys
No.pt 9 3 1 1 1

Table 3: Marital status

Maritual status Married Unmarried
No.pts 11 4

Table 4: Etiology
Etiology During coitus Fall/rolling over erect penis Manipulation of erect penis
No.pts 8 4 3

Table 5: Hospital stay

Hosp.stay 7days 7-10days 10 -15 days
No.pts 2 12 1

Table 6: Site/side wise distribution

Site/side Corpora
Rt Lt distal middle proxi
No. pts 8 7 - 3 12

Figure 1 Fiugure 2 Figure 3

Figure 4 Figure 5

DISCUSSION describe immediate detumescence, severe pain, and

The diagnosis of penile fracture describes the traumatic
rupture of the tunica albuginea of an erect penis. Penile
fractures typically occur when the engorged penile
corpora are forced to buckle and literally pop under the
pressure of a blunt sexual trauma.3 Patients typically
swelling as a result of the injury. Detumescence occurs
rapidly, and acute swelling, pain, and penile deformity
follow. The pain can vary from minimal to severe and is
not proportionate to the degree of injury. The majority of
cases are the result of traumatic coitus, usually from

Copyright 2015, Statperson Publications, MedPulse International Medical Journal, ISSN: 2348-2516, EISSN: 2348-1897, Volume 2, Issue 3 March 2015
 Venkat Arjunrao Gite, Anita Jagdish Kandi
thrusting an erect penis against the symphysis pubis or
perineum. In Japan, only 19% of cases are attributed to
sexual intercourse, with the majority of cases reported as
the result of masturbation and rolling over in bed onto an
erect penis. The gross appearance of a fractured penis is
often summarized as an eggplant deformity, which
refers to the combination of localized penile swelling,
discoloration, and deviation toward the opposite side of
the fracture.5 The current literature generally advocates
immediate surgical repair upon presentation to the
hospital. In the event of a delayed presentation (48 hours
after injury), immediate repair is still advocated, although
it is associated with increased risk of long-term sequelae.6
The type and location of the incision is operator
dependent, although we use and recommend a distal
circumferential degloving incision, as advocated by
McAninch and others.2 In addition to being the most
cosmetic incision, distal degloving readily allows
exposure to the entire tunica bilaterally, facilitating
diagnosis and repair of coexisting urethral and contra
lateral injuries.5 For an unknown reason, significantly
more lesions occur to the right corpora, with the right-
side incidence as high as 75%.1,7 The decision to place a
Foley catheter is operator dependent. McAninch and
Mydlo routinely catheterized their patients overnight in
their series.8,9 Zargooshi concludes on the basis of his
series of 172 patients that routine urethrography is
unnecessary. Management of urethral injuries is highly
variable between series. Treatment options for partial
urethral tears include urethral catheterization, primary
closure with nonabsorbable suture, or suprapubic
cystostomy tube. . Other investigators report excellent
results after primary repair. Partial tears managed strictly
with Foley catheterization did equally well.3 Complete
urethral injuries can be managed with primary
MedPulse International Medical Journal, ISSN: 2348-2516, EISSN: 2348-1897, Volume 2, Issue 3, March 2015
reanastamosis, graft interposition, or stenting over a
urethral catheter10
CONCLUSION
The diagnosis of penile fracture is mostly a clinical one.
Early presentation, Prompt surgical exploration and repair
are advocated in almost all cases, Immediate surgery
reduces long-term complications.
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Source of Support: None Declared
Conflict of Interest: None Declared
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