Management of Fracture of the Penis in Qatar

Abstract

We present 21 patients with fracture of the penis treated between July 1982 and July 1990. Eighteen patients were treated surgically, with good functional and morphological recovery; 3 refused surgery, 1 of whom had penile deformity and pain on erection. The literature is reviewed with respect to the necessity of different diagnostic and therapeutic options.

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

“…1,6,[23][24][25] The mean age in this series, 36 years, falls within this range. In seven of our 12 patients (57%), the fracture incidents were related to sexual intercourse, which is similar to the 58% reported by Nicolaison et al 24 from the West, but varies greatly with the 9.5% reported by El-Sherif et al 6 from a neighboring Gulf state. One patient had a fracture twice in five years, and to the best of our knowledge no such recurrent fracture has been reported before.…”

“…4 This harmful angulation usually occurs during coitus, 5 masturbation or nocturnal unconscious manipulation. 6 Pathologically, the lesion consists of a tear in the tunica albuginea. Bleeding will result in the formation of a hematoma, and distortion and discoloration of the penis.…”

“…1 There may be an associated injury to the corpus spongiosum or urethra. 7 The extravasation of blood, urine or both may extend to the scrotum, the perineum and the inguinal region, 6,8 if Buck's fascia is torn. The patient may recall hearing a cracking sound followed by detumescence of the erect penis, and at times intense local pain.…”

Acute penile trauma and associated morbidity: 9-year experience at a tertiary care center

“…Classically, patients will report a cracking or popping sound during intercourse, followed by rapid detumescence and penile pain, swelling, and bruising. Examination reveals a tender and significantly swollen penis, often with the typical 'eggplant' deformity, as hematoma collects deep to Buck's fascia (El-Sherif et al, 1991;Zargooshi, 2000;Sawh et al, 2008;Al-Shaiji et al, 2009). Differential diagnosis includes injury to the dorsal artery or veins producing a hematoma deep to the Dartos layer that may be mistaken for a fracture (Shah et al, 2003).…”

“…In the United States, the most common mechanism of injury is buckling of an erect penis against a partner's perineum or pubic symphysis during sexual intercourse (Al-Shaiji et al, 2009;Al-Reshaid et al, 2010;Morey & Dugi, 2012). In the Middle East, the most commonly reported cause is penile manipulation, known as taqaandan or taghaandan, which involves forcibly and manually deflecting an erect penis downward, upward, or in a lateral direction to achieve detumescence (El-Sherif et al, 1991;Zargooshi, 2000).…”