Surgical Management of Penile Fractures
Summary
Penile fracture is an acute urological emergency characterised by rupture of the tunica albuginea enveloping the corpus cavernosum. Typically sustained during vigorous sexual activity or blunt trauma to an erect penis, the injury presents with an audible crack, immediate pain, rapid detumescence and pronounced swelling. Prompt diagnosis relies predominantly on clinical assessment, with adjunctive imaging—such as ultrasound or magnetic resonance imaging—reserved for equivocal cases or suspected urethral injury. Surgical exploration via a subcoronal degloving incision permits evacuation of haematoma, precise identification of the tunical tear and repair with absorbable sutures. Concomitant urethral disruptions are addressed by direct reconstruction during the same procedure. Early operative management minimises the risk of long-term complications, including erectile dysfunction, penile curvature and urethral stricture. Postoperative care encompasses analgesia, antibiotic prophylaxis and a period of sexual abstinence. Recent refinements in surgical access and suture techniques have bolstered functional outcomes, yielding high rates of erectile preservation and patient satisfaction across diverse healthcare settings.
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Surgical Management of Penile Fractures publication trend
The graph below shows the total number of articles in surgical management of penile fractures across all publications each year (not limited to Nature Index journals).
Technical terms
Tunica albuginea: Fibrous sheath surrounding each corpus cavernosum that, when ruptured, defines a penile fracture.
Corpus cavernosum: One of the two erectile bodies of the penis responsible for rigidity during erection.
Contrast enhanced ultrasound (CEUS): Advanced sonographic technique using microbubble contrast agents to visualise tissue vascularity in real time.
Subcoronal degloving incision: Circumferential incision below the glans that facilitates full penile degloving and exposure of the corpora for repair.
Urethral reconstruction: Surgical repair of the urethra in cases of associated urethral injury to restore normal urinary function.
References
- Utility of contrast enhanced ultrasound (CEUS) in penile trauma. Insights into Imaging (2023).
- Urethral injury in penile fracture: a narrative review. International braz j urol (2020).
- Lessons learned after 20 years' experience with penile fracture. International braz j urol (2020).
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