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Penile Fracture and Early Surgical Intervention

Penile Fracture Image

Penile Fracture and Early Surgical Intervention

As odd as it may sound, a spongy and rather soft tissue like penis can also get fractured if excessive force or pressure is applied during full-blown erection phase. Penile fracture is a medical emergency and requires heroic measures to minimize the risk of hazardous complications.

Penile fracture is an uncommon injury and approximately 50% of all the cases are reported in African and Middle Eastern countries.


What Causes Penile Fractures?

An erect penis is engorged with blood that fills the sinuses or spongy cylinders to form a stable anatomical support in order to complete the act of physical intercourse. A sudden or forceful thrust or push on an erect penis may lead to the fracture of these cylinders (also known as corpus cavernosum) and may lead to:

In severe cases when Buck’s fascia is also involved, patients may experience a butterfly pattern of ecchymosis (large bruise) that extends up to scrotum, perineal region and suprapubic region.


Penile Fracture Risk Factors

Some common causes or scenarios during which the risk of penile fracture increases significantly; are:


Early Surgical Intervention in Penile Fractures

Fracture of the shaft of penis is a surgical and medical emergency. A positive history and thorough physical examination is generally sufficient to make the diagnosis of penile fracture. Any delay seeking medical care may lead to permanent complications like:


Surgical Management of Penile Fracture

After assessment and confirmation of the site of injury and severity of fracture, surgeons usually perform corrective surgery under general anesthesia. Most common modalities include, end-to-end anastomosis and surgical suturing.

Study reported in Canadian Urological Association Journal (3) has summarized the surgical procedure in these words:

“The procedure included: evacuation of the hematoma, identification of the site and number of defect, closure of the defect by 4/0 Prolene non-absorbable or 4-0 vicryl absorbable sutures in continuous manner, closure of Bucks fascia in longitudinal direction by running 4/0 chromic sutures, closure of the skin by running 4/0 chromic suture and finally dressing”

Although conservative options are also available to manage penile fracture, most clinicians and investigators believe that surgical correction is the appropriate course. Early intervention is associated with higher chances of complete recovery and restoration of sexual function, as well as shorter hospital stay and minimal risk of permanent curvature deformities of penis (2).

According to a study reported in the peer-reviewed journal Urology (6), investigators reported that despite early surgical intervention, 9 of 30 patients reported some degree of erectile difficulty after the follow-up period. Other long term complications of surgical correction are:

The risk of complications is dependent on the intensity of initial assault, nature of surgical intervention and involvement of urethra.



  1. Mensah, J. E., Morton, B., & Kyei, M. (2010). Early surgical repair of penile fractures. Ghana medical journal, 44(3).
  2. Buyukkaya, R., Buyukkaya, A., Ozturk, B., Kayıkçı, A., & Yazgan, Ö. (2014). Role of ultrasonography with color-Doppler in the emergency diagnosis of acute penile fracture: a case report. Medical ultrasonography, 16(1), 67-69.
  3. Moslemi, M. K. (2013). Evaluation of epidemiology, concomitant urethral disruption and seasonal variation of penile fracture: A report of 86 cases. Canadian Urological Association Journal, 7(9-10), E572.
  4. Gedik, A., Kayan, D., Yamis, S., Yilmaz, Y., & Bircan, K. (2011). The diagnosis and treatment of penile fracture: our 19-year experience. Ulus Travma Acil Cerrahi Derg, 17(1), 57-60.
  5. El-Assmy, A., El-Tholoth, H. S., Abou-El-Ghar, M. E., Mohsen, T., & Ibrahiem, E. H. I. (2011). Risk factors of erectile dysfunction and penile vascular changes after surgical repair of penile fracture. International journal of impotence research, 24(1), 20-25.
  6. Swanson, D. E., Polackwich, A. S., Helfand, B. T., Masson, P., Hwong, J., Dugi, D. D., … & McVary, K. T. (2014). Penile Fracture: Outcomes of Early Surgical Intervention. Urology, 84(5), 1117-1121.




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