Penile fractures: controversy over surgical or conservative treatment

Horst, Christof van der; Portillo, F. J. Martínez; Bannowsky, A.; Seif, C.; Juenemann, Klaus‐Peter

doi:10.1046/j.1464-410x.2003.04347.x

Cited by 16 publications

(18 citation statements)

References 20 publications

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“…This is in accordance with the WHO recommendations [32]. Since the Fetter and Gartmen's description of operative repair of penile fracture in 1936 [33], several approaches have been used.…”

Section: Discussionsupporting

confidence: 77%

A prospective analysis of the presentation and management of penile fracture at the Lagos State University Teaching Hospital (LASUTH), Ikeja, Lagos, Nigeria

Omisanjo

Bioku

Ikuerowo

et al. 2015

African Journal of Urology

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Introduction: Penile fracture though an uncommon urological emergency, can be associated with significant morbidity when it is not properly treated. Its etiology and management vary with geographical location. There are few reports on it in Nigeria. Objective: The aim of our study was to prospectively analyze the aetiological factors, presentation and management of all cases of penile fracture presenting to our hospital over a 5-year period. Subjects and methods: All the patients that presented to our hospital with penile fracture over a 5-year period from October 2008 to September 2013 were studied. The data were collected using a structured proforma documenting patient biodata, presenting complaints, duration of symptoms, aetiological factors, surgery done, intraoperative findings and post-operative complications. Results: There was a total of 15 patients during the study period. The diagnosis was clinical in all cases and confirmed at surgery. The mean age of the patient was 35.2 years. The commonest aetiological factor was vigorous coitus (66.7%). None of the patients presented earlier than 4 h, though most of them (66.7%) presented within 48 h. All the patients (100%) had immediate operative repair. Right sided injuries were Presentation and management of penile fracture at the LASUTH, Nigeria 53 the commonest (53.3%) and overall, there was associated urethral injury in 26.7%. The mean hospital stay was 3.7 days. The identified complications were erectile dysfunction (6.7%) and penile curvature (13.3%). Conclusion: Coitus is the commonest aetiological factor for fracture of the penis in our environment. Though the majority of the patient still present late, immediate surgical repair is associated with a low complication rate.

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“…This is in accordance with the WHO recommendations [32]. Since the Fetter and Gartmen's description of operative repair of penile fracture in 1936 [33], several approaches have been used.…”

Section: Discussionsupporting

confidence: 77%

A prospective analysis of the presentation and management of penile fracture at the Lagos State University Teaching Hospital (LASUTH), Ikeja, Lagos, Nigeria

Omisanjo

Bioku

Ikuerowo

et al. 2015

African Journal of Urology

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“…Günümüz bilgileri ışığında penil fraktür şüphesi ile başvuran her hastaya cerrahi eksplorasyon uygulanması gerekli gibi görün-mektedir [2,[6][7][8][9][10][11]. Ne var ki hastaların bir kısmı doktora çok geç başvurmakta, bir kısmı da tüm uyarılara ve bilgilendirilmeye karşın cerrahi girişimi kabul etmemektedir.…”

Section: Discussionunclassified

“…Bu noktada penil fraktür olgularında cerrahi dışı tedavilerin de geliştirilmesi gerekliliği açıktır. Literatürde konservatif şekilde tedavi edilen olgularda, cerrahi uygulananlara göre daha yüksek komplikasyon oranları bildirilmiştir [7][8][9][10]12]. Kalash ve Young, 1984 yılında yayınlanan derlemelerinde konservatif tedavi ile %10-53 oranında geç komplikasyon geliştiğini bildirmişlerdir [9].…”

Section: Discussionunclassified

Natural Course of Tunica Albuginea Fibrosis and Antifibrotic Effect of Intralesional Verapamil Injection in Rabbits with Penile Fracture Model

Özkan¹,

Sarıbacak²,

Özkan³

et al. 2012

Ann Clin Anal Med

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ÖzetAmaç: Penis fraktürünün konservatif tedavisi sonucunda hastalarda tunika albugineada gelişen fibrozise bağlı olarak daha yüksek oranda komplikasyonlar gelişmektedir. Biz çalışmamızda penil fraktür modeli oluşturulan tavşanlarda tunika albugineada fibrozis gelişiminin doğal sürecini ve intralezyonel verapamil uygulanmasının antifibrotik etkisini araştırmayı planladık. Gereç ve Yöntem: Çalışmaya 3 eşit gruba bölünen 45 tavşan dahil edildi. Birinci gruptaki tavşanların tunika albugineasında bistüri ile lezyon oluşturulduktan sonra 1,2,7 ve 10. günlerde penektomi uygulandı. İkinci gruptaki tavşanlara 3 günde bir 0,1 mg verapamil intralezyonel olarak uygulandı. 3. gruptaki tavşanlara da 1 ay süreyle 3 günde bir, 0,1 mg %0,9' luk NaCl intralezyonel olarak uygulandı. Birinci ay sonunda tüm tavşanlara penektomi yapıldı. Mikroskopide korpus kavernozum ve tunika albugineada inflamasyon, taze ve eski kanama ile fibrozis varlığı değerlendirildi. Bulgular: Kontrol grubunda 48. saatte tunika albugineada fibrotik değişikliklerin başladığı görüldü. Birinci ayda penektomi yapılan tavşanların %83'ünde benzer bulgular saptandı. Verapamil grubundaki tavşanların %54'ünde, serum fizyolojik grubundaki tavşanla-rın ise %70'inde lezyon yerinde fibrozis ve çevrede eski kanama bulguları izlendi. Sonuçlar arasındaki fark istatistiksel olarak anlamlı bulunmadı. Sonuç: Penil fraktür sonrasında tunika albugineada fibrozis 2. günde başlamakta-dır ve 1. ayın sonunda lezyon yerinde yaygın olarak izlenmektedir. İntralezyo-nel verapamil enjeksiyonu fibrozisin önlenmesinde faydalı görünmekle birlikte kesin kanaate varmak için ileri çalışmalara ihtiyaç vardır. Anahtar KelimelerFibrozis; İntralezyonel Enjeksiyon; Penil Fraktür; Verapamil Abstract Aim: Urologic complications are seen frequently after conservative treatment of penile fracture cases due to the fibrosis of tunica albuginea. We aimed to assess the natural course of tunica albuginea fibrosis and the antifibrotic effect of intralesional verapamil treatment in rabbits with penile fracture model. Material and Method: Forty-five rabbits were divided in 3 groups. In the first group, penectomy is performed on day 1, 2, 7 and 30 after penile fracture formation. In the second group, intralesional verapamil is injected every third day and penectomy is performed after 1 month. The third group was the placebo group, where saline solution is injected instead of verapamil in the same way. The specimens were investigated at the pathology department to detect inflammation, hematoma and fibrosis. Results: Fibrosis at tunica albuginea is detected on the second day in the control group. In the first month, %83 of the rabbits in the control group had fibrotic changes at the site of the lesion. In the verapamil group and saline group, fibrosis is found in %54 and %70 of the specimens respectively. The differences between the groups were not statistically significant. Discussion: Fibrosis is beginning on the second day after tunical lesion and can be found on the site of the lesion after 30 days. Intralesi...

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“…Heu te be vor zugt die Mehr zahl der Au toren eine un mit tel ba re ope ra ti ve Ver sorgung der Pe nis frak tur und be glei ten der Ge fäß-oder Ure thral ver let zun gen [12]. In der Li te ra tur wird so gar noch 9 Tage nach Rup tur über er folg rei che ope ra ti ve Ver sor gun gen be rich tet.…”

Section: The Ra Pieunclassified

Äußeres Genitaltrauma

Horst

Naumann

Martinez-Portillo

et al. 2005

Urologe

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This article reviews the current status of information on external male genital injuries, focusing on the causes as well as diagnostic and therapeutic management of this uncommon entity. Because of the high risk of infection and the major importance of preserving fertility, male genital injuries represent a serious urological disorder that demands immediate urological treatment. The diagnostic procedure classically consists of taking a history and inspecting the wound, which provides enough diagnostic information for the correct choice of conservative or surgical treatment. In most cases open injuries of the genitalia require surgical exploration to determine the extent of possible scrotal, testicular, epididymal, cavernous, or urethral damage, to débride nonviable superficial or deep tissue, to drain existing hematomas, or to control active bleeding. Furthermore, the correct therapeutic approach is crucial for preserving fertility and penile erection. In cases where bilateral ablation is necessary, measures to preserve sperm, e.g., testicular or microsurgical sperm extraction, or squeezing the ductus during orchidectomy must be considered.

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Penile fractures: controversy over surgical or conservative treatment

Cited by 16 publications

References 20 publications

A prospective analysis of the presentation and management of penile fracture at the Lagos State University Teaching Hospital (LASUTH), Ikeja, Lagos, Nigeria

A prospective analysis of the presentation and management of penile fracture at the Lagos State University Teaching Hospital (LASUTH), Ikeja, Lagos, Nigeria

Natural Course of Tunica Albuginea Fibrosis and Antifibrotic Effect of Intralesional Verapamil Injection in Rabbits with Penile Fracture Model

Äußeres Genitaltrauma

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