Fracture of the Penis: Surgical Management

Consensus on genitourinary trauma: external genitalia

“…At the time of fracture, the patient typically reports hearing a cracking or popping sound, accompanied by immediate pain and rapid detumescence [33]. Selfinflicted penile fractures occur as a result of aggressive masturbation or manipulating the penis to achieve detumescence [34][35][36].…”

“…Although reported in ª 20% of cases overall, the incidence of concomitant urethral injury is highly variable and mandates a high level of suspicion to exclude this potentially debilitating injury [28,32,35,50,51].…”

Fracture of the Penis: A Critique of Clinical Features and Management

“…This supports the view that urethrography should only be done for suspected urethral injury, 6,8,24 and not for all cases of penile fracture. 1,30 All our patients were managed by early operative intervention. The "conservative management" advocated by some workers in the past 17,21,31 has now been abandoned by most surgeons because of its high complication rate, reaching 25% to 53%.…”

“…The insertion of a urethral catheter perioperatively is still controversial, with some advocating its routine use, 1,8,23,24,30 and others prohibiting such insertion. 6,9,34 In the current study, a urethral catheter was inserted preoperatively after exclusion of any associated urethral injury, and postoperatively in all patients.…”

“…There is also a lack of consensus on the need for postoperative suppression of penile erection with diazepam or estrogen, routinely used in some studies, 23,30 but declared to be unnecessary in other reports. 6,25 In the current series, the use of diazepam helped in the prevention of early erections that might have had harmful effects, and helped to allay patient's anxiety which may occur with such trauma.…”