Penile Fracture

Fracture of the penis is an uncommon injury of the erect penis. This injury most often happens during forceful sexual intercourse, but it may happen under any circumstances when an erection occurs. This is not a fractured bone. The penis contains only soft and fibrous (tough leathery) tissue. The tough fibrous layers inside are the structures which fill up with blood during an erection (hardening of the penis). If a rupture or break of one of these layers occurs, it is called a penile fracture. There may also be injury to the urethra (the tube in the penis which carries the urine from the bladder).

SYMPTOMS

This injury is usually noticed right away because of:

  • Pain.

  • A changed shape of the penis.

DIAGNOSIS

  • The diagnosis can be made by your caregiver talking to you and learning how the injury happened.

  • The diagnosis can be made by examining you.

  • Specialized testing may sometimes be done to confirm a suspected diagnosis or to find out what damage needs to be repaired during surgery. These tests include:

  • Ultrasonography (imaging technique used to look inside the body).

  • Cavernosography (x-ray of the blood flow in the penis).

  • Urethrography (x-ray of the urethra).

TREATMENT

When the problem is severe, it is considered a surgical emergency. The sooner the problem is repaired, the more likely there will be a good result. Emergency surgical repair offers the best chance of recovery with a correct working penis.

If conservative (nonsurgical) treatment is used, there may be other complications such as:

  • A bulging out of the side of the penis (aneurysm)

  • Scarring and hardening of the penis

  • Abnormal curvature

  • Erectile dysfunction (problems with impotence)

  • The final outcome will be unsatisfactory or poor.

Minor cases of fractured penis may be treated conservatively. The decision to treat conservatively or with surgery should be made with your urologist to fully understand the pros and cons of these different treatments.