Traumatic penile injuries: Mechanisms and problems of treatment in a tertiary institution in Nigeria

Abstract

Background: Penile injuries are uncommon. The more severe injuries are often difficult to manage.

Objectives: We report our experience with penile injuries from different causes and treatment options available.

Patients and methods: We analyzed retrospectively 23 cases of penile injuries presenting to the Urology Unit of a tertiary hospital in the Southeastern part of Nigeria from January 2007 to December 2012.

Results: The management for each patient varied depending on the nature and extent of the injury. The mean age of the patients was 28.9 ± 14.4 years (range 3 weeks to 43 years). The mean duration before presentation was 22.7 ± 17.8 h (range 1-168 h). The causes of penile injuries were categorized as follows: Postcircumcision 3 (13.0%), genital mutilation (self-inflicted injury/attacks by assailants) 6 (26.1%), accident 4 (17.4%), penile fracture 8 (34.8%), and gunshot injury 2 (8.6%). Isolated blunt injuries to the corporal tissues as occurs in penile fractures was managed successfully with early exploration and closure of the tunical tear, while injuries to the penile skin was managed with dressing and secondary closure. Severe penile injuries resulting in partial or total phallic loss presented the most challenge to treatment.

Conclusion: Traumatic penile injuries are not common. Severe penile injuries could be challenging because of the nature of the injuries, delayed presentation and unavailability of modern technological tools and experience required for the treatment of such severe injuries. Expertise in the use of flaps for a neophallus are still been developed, and penile prosthetic devices are not readily available in our setting.