What is Penile Fracture?
Penile Fracture occurs mostly because of a direct blow or trauma to an erect penis. It is a medical emergency and prompt treatment needs to be administered if an individual is believed to have sustained a Penile Fracture. In a Penile Fracture, there is a tera of the tunica albuginea which is a white colored membrane that functions by getting and maintaining erection of the penis. The tear of this structure occurs usually as a result of vigorous sexual intercourse, forceful masturbation, or an injury to an erect penis like a gunshot wound or removing or wearing clothes in a hurry with the penis erect. In some cases, just turning over in bed when the penis is erect may also lead to Penile Fracture.[1]
Among all the causes mentioned above, the most common mechanism of a Penile Fracture is sexual intercourse when the penis moves out of the vagina and strokes against the perineum or the symphysis pubis. Studies estimate that 60% of all Penile Fractures occur as a result of consensual sexual intercourse. Penile Fracture is a condition which most people hesitate to report due to the embarrassment associated with it. Studies estimate that only about 1 in 175,000 people in the United States report that they have Penile Fracture.[1]
However, it is the eastern part of the globe where majority of cases of Penile Fracture are reported to an extent of a case every week even though many people do not seek treatment due to sheer embarrassment.[1]
What Causes Penile Fracture?
Anatomically speaking, the penis contains a spongy tissue referred to as corpus cavernosa. This is the area where all the blood is concentrated in when an individual has an erection. It is when this corpus cavernosa snaps out is when an individual is said to have developed a Penile Fracture. In almost all the cases, Penile Fracture occurs when the penis is fully erect. This is because when the penis is not erect the corpus cavernosa does not have blood in it and as a result is not enlarged enough to snap out of place.[2]
Studies suggest that majority of the cases of Penile Fracture occur during a sexual intercourse. It happens during thrusting of the penis within the vagina. This is when the penis strikes against the perineum causing the corpus cavernosum to snap. It is more the position that the male is in during sexual intercourse rather the roughness which results in a Penile Fracture. In some cases, Penile Fracture occurs by rolling over the bed on an erect penis.[2]
A Penile Fracture can also occur if an erect penis gets hit hard like on furniture or a doorframe. A direct fall on to the penis can also be a potential cause for a Penile Fracture.[2]
What are the Symptoms of Penile Fracture?
Penile Fracture can be extremely painful. It is the lower half of the penis that gets affected by a penile fracture. The individual will also experience bleeding from the penis. There will be discoloration of the penile area. There will also be problems with urinating. There will also be a sudden loss of erection after the injury. There will also be an audible popping sound from the penile area. If an individual experiences other symptoms of Penile Fracture but does not have a popping sound and sudden loss of erection is generally caused by some other form of injury and should investigated.[2]
An individual with Penile Fracture will have a swollen penis and there will be a visible deformity. In rare cases, there may also be hematuria. Some of the medical conditions that have symptoms similar to a Penile Fracture include ruptured veins and arteries of the penis.[2]
How Is Penile Fracture Diagnosed?
To diagnose a Penile Fracture, the physician will begin with taking the history of the patient. The physician will inquire as to how the injury occurred. The physician will then closely inspect the penis to look for signs of deformity, discoloration, and swelling. The physician will then order radiographs in the form of x-rays or in some cases ultrasound to look for any abnormalities in the penile area or any area of damage to the penis.[2]
An MRI of the penis may also be done for this purpose. Depending on the results of the history, physical examination, and radiographs a diagnosis of Penile Fracture will be made.[2]
How is Penile Fracture Treated?
Penile Fracture usually requires surgical repair. However, there are also certain home remedies that also can work for treatment of this condition. For treating Penile Fracture at home, application of ice packs for 15-20 minutes two to three times a day to calm down the swelling can be quite effective. An individual can also use a Foley catheter to empty the bladder and put less strain on the penis. Antiinflammatory medications in the form of ibuprofen and Tylenol are also quite effective for treating Penile Fracture.[2]
In some cases, physicians may put the penis in a splint for a few days to decrease pressure being put on the penis till the time the fracture heals. The treatments mentioned above in some cases can lead to certain complications to include pain during an erection, the penis will be angled, and there will be difficulty in getting and maintaining a full erection for any considerable period of time. This is the reason why many physicians resort to surgical repair to treat Penile Fracture for a better prognosis and quality of life.[2]
The surgery will involve removal of any hematoma that may have formed due to the pooling of blood after the fracture. The surgery will also stop any blood vessel bleeding due to damage caused to it by the Penile Fracture. The surgeon will also close any lacerations or cuts which may have resulted in bleeding after the fracture. In case if the urethra gets damaged due to Penile Fracture then surgery will also address that as well.[2]
During surgery, the surgeon will make an incision and get access to the torn area of the corpus cavernosum. This will then be repaired by stiches. The wound will be dressed and allowed to heal. The recovery phase of Penile Fracture depends on the severity of the condition. It is usually recommended for the patient to refrain from any sexual activity for at least a month after treatment to allow the fracture to heal. In some cases, if an individual has problems with urination or has pain in the penile area then medications may need to be prescribed to treat it.[2]
The patient may also at times be given medications to reduce erections during the recovery phase after treatment of Penile Fracture. If Penile Fracture remains untreated, then there is a high likelihood of a permanent penile deformity. The patient may also end up having erectile dysfunction. Thus, immediate treatment of Penile Fracture is of paramount importance so that the individual can return to normal sexual function and have no problems with urinary function.[2]
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