Penile fracture in Kermanshah, Iran: report of 172 cases

Abstract

Purpose: Experience with 172 cases of penile fracture, in Kermanshah, Iran is reviewed.

Materials and methods: Records of penile fracture cases were reviewed from April 1990 to October 1999.

Results: Diagnosis was made clinically and there was no need to perform cavernosography in any case. The most common mechanism of fracture was referred to by patients as "taghaandan" (to click or snap when forcibly pushing the erect penis down to achieve detumescence). All but 2 cases were treated surgically and 2 cases had concomitant urethral injury diagnosed by selective urethrography. Repair consisted of a circumferential degloving incision to evaluate the corpora. Because of unavailability of synthetic absorbables, inverted knot nylon sutures were used successfully for repair. Delay in operation did not increase difficulty in dissection or early postoperative morbidity. Preoperative and postoperative use of antibiotics was effective in eliminating risk of infection. There were no significant intraoperative or immediate postoperative complications and most patients were discharged home on postoperative day 1.

Conclusions: Patient misinformation about penile tissue properties is the main explanation for the high incidence of penile fracture. Cavernosography, and urethrography and intraoperative urethral catheterization are not routinely needed, as diagnosis can be made clinically. Preoperative and postoperative use of antibiotics, and a uniform surgical plan regardless of delay in presentation are recommended.