OUTCOMES OF SURGICAL MANAGEMENT OF FRACTURE PENIS: EXPERIENCE FROM A TERTIARY CARE HOSPITAL IN BANGLADESH

Md. Selim Morshed, AKM Musa Bhuyian, Mohammad Saruar Alam, Md. Towhid Belal, Sayem Hossain, Mohammad Ibrahim Ali, Sojib Bin Zaman

Abstract


Background: Penile fracture is an emergency and uncommon presentation to the urology department. Immediate surgical repair can be a standard of care for patients with penile fracture.

Objective: The study was conducted to evaluate the outcome of surgical repair of the fractured penis.

Methods: This quasi-experimental study was conducted from Jan 2017 to Dec 2018 in the urology department of Dhaka Medical College Hospital, Bangladesh. Thirty-five patients with fractures of the penis were included in this study. After proper evaluation, surgery was performed under spinal anesthesia. Follow up was scheduled at 6th week, 3rd month, and 6th month. We used validated questionnaires of the ‘International index of erectile function (IIEF-5)’ for married and ‘Single question self-report (SQSR)’ for unmarried patients to evaluate postoperative erectile function.

Results: Total 35 patients completed three follow up. The mean age of patients was 36.4 years, and 88% of them were married. The most common triggers were for vigorous sexual intercourse (68.5%) followed by history of rolling over in bed with erect penis (20.0%). Per-operative findings were: rupture of tunica albuginea (100%); rupture of corpora cavernosa on the right (65.7%). After 6th month, 28 patients (80%) were able to maintain their normal erectile function. However, seven patients developed erectile dysfunction, of which 4 had a mild form, and 3 had mild to moderate form erectile dysfunction. All patients complained of pain during or after intercourse, but the pain has gradually subsided with time.

Conclusion: Immediate surgical exploration and repair of fracture penis can offer complete recovery of sexual and voiding functions.


Keywords


fracture penis, surgical management, Bangladesh

Full Text:

PDF

References


Aaronson, D. S., & Shindel, A. W. (2010). US national statistics on penile fracture. The Journal of Sexual Medicine, 7(9), 3226.

Agarwal, M. M., Singh, S. K., Sharma, D. K., Ranjan, P., Kumar, S., Chandramohan, V., . . . Mavuduru, R. (2009). Fracture of the penis: a radiological or clinical diagnosis? A case series and literature review. Canadian Journal of Urology, 16(2), 4568.

Al‐Shaiji, T. F., Amann, J., & Brock, G. B. (2009). Fractured Penis: Diagnosis and Management (CME). The Journal of Sexual Medicine, 6(12), 3231-3240.

Asgari, M., Hosseini, S., Safarinejad, M., Samadzadeh, B., & Bardideh, A. (1996). Penile fractures: evaluation, therapeutic approaches and long-term results. The Journal of Urology, 155(1), 148-149.

Ateyah, A., Mostafa, T., Nasser, T. A., Shaeer, O., Hadi, A. A., & Al‐Gabbar, M. A. (2008). Penile fracture: surgical repair and late effects on erectile function. The Journal of Sexual Medicine, 5(6), 1496-1502.

Bella, A. J., Sener, A., Foell, K., & Brock, G. B. (2007). Case report: Nonpalpable scarring of the penile septum as a cause of erectile dysfunction: an atypical form of peyronie’s disease. The Journal of Sexual Medicine, 4(1), 226-230.

Bhatt, S., Kocakoc, E., Rubens, D. J., Seftel, A. D., & Dogra, V. S. (2005). Sonographic evaluation of penile trauma. Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine, 24(7), 993-1000; quiz 1001.

De Luca, F., Garaffa, G., Falcone, M., Raheem, A., Zacharakis, E., Shabbir, M., . . . Akers, C. (2017). Functional outcomes following immediate repair of penile fracture: a tertiary referral centre experience with 76 consecutive patients. Scandinavian Journal of Urology, 51(2), 170-175.

El Housseiny, I. I., El-Tholoth, H. S., Mohsen, T., Hekal, I. A., & El-Assmy, A. (2010). Penile fracture: long-term outcome of immediate surgical intervention. Urology, 75(1), 108-111.

El-Assmy, A., El-Tholoth, H. S., Mohsen, T., & El Housseiny, I. I. (2011). Does timing of presentation of penile fracture affect outcome of surgical intervention? Urology, 77(6), 1388-1391.

El‐Assmy, A., El‐Tholoth, H. S., Mohsen, T., & Ibrahiem, E. H. I. (2010). Long‐term outcome of surgical treatment of penile fracture complicated by urethral rupture. The Journal of Sexual Medicine, 7(11), 3784-3788.

Gamal, W. M., Osman, M. M., Hammady, A., Aldahshoury, M. Z., Hussein, M. M., & Saleem, M. (2011). Penile fracture: long-term results of surgical and conservative management. Journal of Trauma and Acute Care Surgery, 71(2), 491-493.

Ghilan, A. M., Al-Asbahi, W. A., Ghafour, M. A., Alwan, M. A., & Al-Khanbashi, O. M. (2008). Management of penile fractures. Saudi Medical Journal, 29(10), 1443-1447.

Gómez, B. G., Romero, J., Villacampa, F., Tejido, A., & Diaz, R. (2012). Early treatment of penile fractures: our experience. Archivos españoles de urología, 65, 684-688.

Hatzichristodoulou, G., Dorstewitz, A., Gschwend, J. E., Herkommer, K., & Zantl, N. (2013). Surgical management of penile fracture and long‐term outcome on erectile function and voiding. The Journal of Sexual Medicine, 10(5), 1424-1430.

Hinev, A. (2000). Fracture of the penis: treatment and complications. Acta Medica Okayama, 54(5), 211-216.

Kamdar, C., Mooppan, U. M., Kim, H., & Gulmi, F. A. (2008). Penile fracture: preoperative evaluation and surgical technique for optimal patient outcome. BJU international, 102(11), 1640-1644.

Koifman, L., Barros, R., Júnior, R. A., Cavalcanti, A. G., & Favorito, L. A. (2010). Penile fracture: diagnosis, treatment and outcomes of 150 patients. Urology, 76(6), 1488-1492.

Konnak, J. W., & Ohl, D. A. (1989). Microsurgical penile revascularization using the central corporeal penile artery. The Journal of urology, 142(2), 305-308.

Kozacioglu, Z., Degirmenci, T., Arslan, M., Yuksel, M. B., Gunlusoy, B., & Minareci, S. (2011). Long-term significance of the number of hours until surgical repair of penile fractures. Urologia Internationalis, 87(1), 75-79.

Lee, S. H., Bak, C. W., Choi, M. H., Lee, H. S., Lee, M. S., & Yoon, S. J. (2008). Trauma to male genital organs: A 10‐year review of 156 patients, including 118 treated by surgery. BJU International, 101(2), 211-215.

Mazaris, E. M., Livadas, K., Chalikopoulos, D., Bisas, A., Deliveliotis, C., & Skolarikos, A. (2009). Penile fractures: immediate surgical approach with a midline ventral incision. BJU International, 104(4), 520-523.

Miller, S. (1996). Penile fracture and soft tissue injury. Traumatic and Reconstructive Urology. 33(2), 95-102.

Montorsi, F., Adaikan, G., Becher, E., Giuliano, F., Khoury, S., Lue, T. F., . . . Brock, G. (2010). Summary of the recommendations on sexual dysfunctions in men. The Journal of Sexual Medicine, 7(11), 3572-3588.

Mydlo, J. H. (2001). Surgeon experience with penile fracture. The Journal of Urology, 166(2), 526-529.

Nason, G. J., McGuire, B. B., Liddy, S., Looney, A., Lennon, G. M., Mulvin, D. W., . . . Quinlan, D. M. (2013). Sexual function outcomes following fracture of the penis. Canadian Urological Association Journal, 7(7-8), 252.

Özen, H., Erkan, I., Alkibay, T., Kendi, S., & Remzi, D. (1986). Fracture of the penis and long‐term results of surgical treatment. British Journal of Urology, 58(5), 551-552.

Penson, D. F., Seftel, A. D., Krane, R. J., Frohrib, D., & Goldstein, I. (1992). The hemodynamic pathophysiology of impotence following blunt trauma to the erect penis. The Journal of Urology, 148(4), 1171-1180.

Ralph, D., Gonzalez-Cadavid, N., Mirone, V., Perovic, S., Sohn, M., Usta, M., & Levine, L. (2010). Trauma, gender reassignment, and penile augmentation. The Journal of Sexual Medicine, 7(4), 1657-1667.

Sawh, S., O'leary, M., Ferreira, M., Berry, A., & Maharaj, D. (2008). Fractured penis: a review. International Journal of Impotence Research, 20(4), 366.

Seftel, A. D., Haas, C. A., Vafa, A., & Brown, S. L. (1998). Inguinal scrotal incision for penile fracture. The Journal of Urology, 159(1), 182-184.

Su, L.-M., Sutaria, P. M., & Eid, J.-F. (1998). Repair of penile rupture through a high-scrotal midline raphe incision. Urology, 52(4), 717-719.

Vig, M., Vig, V., & Suchak, S. (2016). Penile fracture: presentation, management and erectile function following surgical repair. International Journal of Medical and Dental Sciences, 5(2), 1192-1197.

Yacobi, Y., Tsivian, A., & Sidi, A. A. (2007). Emergent and surgical interventions for injuries associated with eroticism: a review. Journal of Trauma and Acute Care Surgery, 62(6), 1522-1530.

Zargooshi, J. (2000). Penile fracture in Kermanshah, Iran: report of 172 cases. The Journal of Urology, 164(2), 364-366.

Zargooshi, J. (2009). Sexual function and tunica albuginea wound healing following penile fracture: An 18‐year follow‐up study of 352 patients from Kermanshah, Iran. The Journal of Sexual Medicine, 6(4), 1141-1150.




DOI: https://doi.org/10.36685/phi.v5i4.313

Refbacks

  • There are currently no refbacks.


Copyright (c) 2019 Sojib Bin Zaman

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

PHI is Indexed in:

PHI is registered and being evaluated by:

Copyright 2015-2018 Public Health of Indonesia | e-ISSN 2477-1570 | p-ISSN 2528-1542 licensed under a Creative Commons Attribution-NonCommercial 4.0 International License