Penis fracture
With the term of penis fracture we are referring to rupture of the corpus cavernosum when the penis is in complete erection.
Usually presented right while extremely rare may involve both sides. It usually presented in men aged 20-50 years, with higher rates among the second and third decade.
There are two necessary conditions for penis fracture:
- Complete erection
- Violent injury
It is important to know that in some cases this condition is accompanied by rupture or injury of the urethra, which must necessarily be investigated before addressing the injury.
Causative factors
- Sexual contact (rate 30-60 %)
- masturbation
- external injuries
- Non-conscious manipulations during sleep or when changing position in bed
Symptoms
- Sound fracture (the patient describes a sound like breaking “branch” or bone)
- Acute pain and simultaneously
- Loss of erection
- Difficulty urinating or inability to urinate even (if done attendant rupture urethra)
Clinical
- Swelling penis
- Hematoma which can be only in the penis and scrotum or can be extended up to the abdomen
- Derogation – angulation of the body of the penis
- Ourithrorragia (participation in the urethra)
Diagnosis
Based on history and physical examination. In case of doubt or when we want to highlight the level of rupture is completed by the following imaging :
- Ultrasound penis (which recognizes the hematoma)
- Sirangografia
- Ourithrografia ( if suspected involvement of the urethra)
- Magnetic resonance imaging
Differential Diagnosis
- Rupture dorsal vein or artery of the penis
- Early stage gangrene Fournier.
Treatment
The treatment of the disease may be conservative or surgical.
The conservative treatment includes:
- Packs
- Banded
- Antibiotics
- Fibrinolytics
- Analgesics
- Granting preparations inhibit erection.
The conservative treatment is accompanied by high rates of erectile dysfunction and should be applied in highly selected cases after we inform our patient about possible complications.
The choice of treatment of penile fracture is surgical treatment and directly within 5 hours of the incident. Studies have revealed that in this manner substantially decreases the likelihood of posttraumatic erectile dysfunction, without of course eliminated.
During surgery recognized the rupture and sutured while checking and possible injury to the urethra.
Controlling the patient will be one month after controlling erectile function.