Sexual complications of penile frature in men who have sex with men

Abstract

Objectives:Evaluate the demographic data, etiology, operative findings and results of surgical treatment of penile fracture (PF) in men who have sex with men(MSM) with emphasis on sexual complications.Materials and Methods:We studied 216 patients underwent surgical correction of PF at our hospital. Patients self-identified as MSM were followed for at least 6 months. Demographic data, presentation, operative findings, International Index of Erection Function - 5 (IIEF-5) and the Premature Ejaculation Diagnostic Tool.Results:Of 216 PF cases, 4 (1.8%) were MSM. All cases resulted from sexual activity and all patients reported using the “doggy style” position during anal intercourse. Unilateral or bilateral injury of corpus cavernosum was found in 2 patients each. One (25%) patient had complete urethral injury associated with bilateral corpus cavernosum lesion. During the follow-up period, all patients developed some type of sexual complication. One patient reported penile pain during intercourse. Another patient experienced low sexual desire and premature ejaculation. This patient was also dissatisfied with the aesthetic result of the surgical scar and complained about decreased penis size after surgery. The third case developed delayed ejaculation. The fourth patient experienced mild to moderate erectile dysfunction. This same patient presented with penile curvature. Finally, palpable fibrotic nodules in the operative area were observed in all cases.Conclusions:Sexual activity in the “doggy style” position was the commonest cause of PF in MSM. Sexual dysfunction is always present in gay man after surgery for PF. However, additional studies with larger samples should be coinducted.

The effect of a penile fracture on ejaculatory and erectile functions: A cross-sectional study

“…Barros et al reported premature ejaculation and delayed ejaculation cases after penile fracture in their study [10]. However, data on sexual function after an injury is limited.…”

“…Complications such as erectile dysfunction, penile deviation, priapism, urethrocavernosal fistula, and urethral stricture may occur despite immediate surgical intervention [9]. Ejaculatory problems were reported after penile fracture in a recent study [10]. Ejaculatory dysfunction may be related to the penile injury or post-traumatic emotional conditions.…”

Findings regarding non-sexual penile fracture in a referral emergency hospital

“…Etiology can vary due to many factors, such as geographic region, sociocultural characteristics, marital status and masturbation habits. Heterosexual vaginal intercourse is reported as the main cause of PF in the World, and there have been reports of occurrence during homossexual anal coitus (7). In Mediterranean and Middle Eastern countries, the majority of cases result from self-inflicted penile manipulation during erection to achieve detumescence (8).…”

Urethral injury in penile fracture: a narrative review

“…RGU is recommended when abnormalities are found in the IPSS questionnaire or uroflowmetry to identify possible urethral stricture or other complications. (8,(22)(23)(24). Short penile urethral stenosis can be treated with sequential dilatations (4,21).…”