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Inicio Actas Urológicas Españolas (English Edition) Consequences of penile fracture: Complications and long-term functional outcomes
Journal Information
Vol. 46. Issue 3.
Pages 178-183 (April 2022)
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Vol. 46. Issue 3.
Pages 178-183 (April 2022)
Original article
Consequences of penile fracture: Complications and long-term functional outcomes
Consecuencias de la fractura de pene: complicaciones y resultados funcionales a largo plazo
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M.R. Peradejordi Font, C. Mercader Barrull
Corresponding author
cmercader@clinic.cat

Corresponding author.
, J.M. López Martínez, J.M. Corral Molina, E. García Cruz, A. Alcaraz Asensio, L. Peri Cusi
Departamento de Urología, Hospital Clínic de Barcelona, Barcelona, Spain
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Tables (3)
Table 1. Frequency of symptoms and signs presented at the emergency department by patients with intraoperatively confirmed penile fracture.
Table 2. Location of the albuginea injury and association of urethral lesion according to location.
Table 3. Long-term functional outcomes after penile fracture with a mean follow-up of 7.4 ± 3.9 years.
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Abstract
Introduction

Penile fracture (PF) is a urological emergency with low incidence, and evidence of its long-term outcomes is scarce. This study focuses on postoperative complications and long-term functional outcomes in patients with PF and surgical repair at our center.

Materials and Method

Clinical records of patients undergoing urgent surgery for PF at a third level hospital between 2006 and 2020 were retrospectively reviewed. Functional outcomes were assessed with voluntary telephone interviews from June 2020 to February 2021. Lower urinary tract symptoms were screened by IPSS questionnaire, sexual function by EHS and IIEF-5 and morphological alterations by direct questions to patients.

Results

A total of 41 patients underwent surgery for PF. Eleven of them also had urethral injury (higher incidence if there was bilateral corpora cavernosa injury, 19.4% vs. 80%, p < 0.05). Only 1 patient presented a Clavien-Dindo type 3a complication due to wound dehiscence, 4 (13%) type 2 and 9 (29%) type 1. Twenty-four patients underwent long-term follow-up, of whom 20 (83.3%) presented normal sexual function. Twelve patients (50%) had a palpable nodule at the fracture site, 8 (33.3%) had new onset penile curvature and 1 patient with previous urethral injury presented urethral stricture.

Conclusion

In cases of penile fracture, there is a higher incidence of urethral injury if both corpora cavernosa are affected. Long-term functional sequelae after surgical repair of a PF are rare.

Keywords:
Penis
Fracture
Erection
Urethra
Sex
Resumen
Introducción

La fractura de pene (FP) es una urgencia urológica con baja incidencia, por lo que existe poca evidencia de los resultados a largo plazo. Este estudio se centra en las complicaciones postoperatorias y resultados funcionales a largo plazo en pacientes que han sufrido una FP reparada quirúrgicamente en nuestro centro.

Materiales y métodos

Los registros clínicos de pacientes sometidos a cirugía urgente por FP en un hospital de tercer nivel entre 2006 y 2020 se revisaron retrospectivamente. Los resultados funcionales se evaluaron con visitas telefónicas voluntarias desde junio del 2020 a febrero del 2021. Se realizó un screening de sintomatología del tracto urinario inferior mediante el cuestionario IPSS, de función sexual mediante el EHS y el IIEF-5 y alteraciones morfológicas mediante pregunta directa a los pacientes.

Resultados

41 pacientes fueron sometidos a cirugía por FP. 11 de ellos además asociaron lesión uretral (mayor incidencia si había lesión de ambos cuerpos cavernosos, 19,4% vs 80%, p < 0,05). Sólo 1 paciente presentó una complicación Clavien-Dindo tipo 3a por dehiscencia de herida, 4 (13%) tipo 2 y 9 (29%) tipo 1. 24 pacientes realizaron seguimiento a largo plazo, de los cuales 20 (83,3%) presentaban una función sexual normal. 12 (50%) presentaban un nódulo palpable en la zona de la fractura, 8 (33,3%) curvatura peneana de nueva aparición y 1 paciente con lesión uretral previa presentó estenosis de uretra.

Conclusión

En la fractura de pene, hay más incidencia de lesión uretral si se afectan ambos cuerpos cavernosos. Las secuelas funcionales a largo plazo tras la reparación quirúrgica de una FP son poco frecuentes.

Palabras clave:
Pene
Fractura
Erección
Uretra
Sexo

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