Fulda-Graue SD, Urdiales A, Santana Z, Pérez R, Morales G, Pacheco-Gahbler C, Calderón-Ferro F

Language: Spanish
References: 8
Page: 235-237
PDF size: 2015.26 Kb.

ABSTRACT

Objective: To present and analyze six cases of penile fracture in relation to immediate progression, diagnosis and management.
Materials and methods: Case records of patients diagnosed with penile fracture were retrolectively (4 years) reviewed. Case history, action mechanism, physical examination, diagnosis, management, findings and surgical complications were analyzed. The review included 6 patients with ages ranging from 26 to 70 years. Fracture occurred in 4 patients during coitus and was self-inflicted in 2 patients. Deformity, hematoma and numbness were present in all 6 patients. None presented with transurethral bleeding. Immediate progression was under 12 hours and diagnosis was clinical. Patients underwent exploratory surgery. Five patients presented with unilateral injury in the tunica albuginea and one patient presented with injury in the dorsal vein. Follow-up protocol was carried out for six months. One patient presented with foreskin necrosis that was managed with mechanical washing and necrotic tissue debridement. The other five patients did not present with complications. Sexual and anatomical functions were conserved.
Discussion: The tunica albuginea is the most resistant fascia of the human body but during erection it loses that quality. In its flaccid state it is approximately 2.4 mm thick and when erect it is between 0.25 and 0.5 mm thick. It is most fragile during erection. Fracture is clinically diagnosed. Rupture is not able to be seen with ultrasonography. When urethral injury is suspected cystourethrography must be performed for rule-out diagnosis. Conservative management is the cause of 40% of penile deviation and erectile dysfunction complications. Dorsal vein injury can appear to be a corpus cavernosum fracture by causing important hematoma and penile deviation.

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