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1.
J Sex Med ; 2024 Sep 20.
Artículo en Inglés | MEDLINE | ID: mdl-39304178

RESUMEN

BACKGROUND: Despite knowledge of the pathophysiology and clinical complications of connective tissue diseases (CTD), little is known regarding their impact on men's sexual health disorders. AIM: To investigate the prevalence of penile fracture (PF) in patients with Ehlers-Danlos Syndrome (EDS) and Marfan syndrome (MFS) in comparison with disease-free controls between 18 and 45 years of age. METHODS: A multicenter, international, electronic health record network (TriNetX) was queried to identify adult male patients (between 18 and 45 years) with or without EDS and MFS between 1993 and 2023 using ICD-10 codes. The prevalence of PF was compared between patients with and without the diseases of interest. Prevalence ratios (PR) were generated with 95% confidence intervals. OUTCOME: Prevalence of PF in patients with EDS and MFS when compared to disease-free controls. RESULTS: The number of patients with EDS, MFS, and control groups was 8060, 8642, and 20 184 547, respectively, with a mean age of 27.8 ± 7.58, 28.6 ± 7.4, and 31.6 ± 8.04 years. Men with EDS had a higher prevalence of PF (PR 30.18, 95% CI [17.08-53.19]; P < 0.0001). Similarly, men with MFS had a higher prevalence of PF (PR 23.4, 95% CI [12.6-43.7]; P < 0.0001). CLINICAL IMPLICATIONS: This study demonstrates an association between CTD and men's sexual health disorders. It may be important to counsel such men about the risks of PF. STRENGTHS AND LIMITATIONS: This is the largest study to date to demonstrate an association between CTD and men's sexual health disorders. While the large sample sizes in this study contribute to the robustness of the findings, the study is limited by the use of a claims-based dataset, which does not provide further details about disease course and complications, and the use of a univariate analysis only. CONCLUSIONS: Patients with EDS and MFS are possibly at an elevated risk for PF. Due to the limitations of the TriNetX database, the analysis was limited to a univariate one, thus limiting the ability to control for confounders and limiting the generalizability of these findings. Further prospective research is needed to corroborate these findings.

2.
Urologiia ; (1): 96-99, 2024 Mar.
Artículo en Ruso | MEDLINE | ID: mdl-38650413

RESUMEN

A clinical case of a penile fracture as a result of an unsuccessful sexual intercourse, which later required surgical treatment in the form of corporoplasty with opening and draining of the hematoma, is discussed in the article. Penile fracture is a rare urological emergency that requires immediate medical attention to avoid long-term complications, including penile curvature and erectile dysfunction.


Asunto(s)
Pene , Humanos , Masculino , Pene/lesiones , Pene/cirugía , Rotura/cirugía , Adulto , Coito , Hematoma/cirugía , Hematoma/etiología , Hematoma/diagnóstico por imagen , Enfermedades del Pene/cirugía , Enfermedades del Pene/etiología
3.
BJU Int ; 132(6): 651-655, 2023 12.
Artículo en Inglés | MEDLINE | ID: mdl-37905382

RESUMEN

OBJECTIVES: To explore whether Christmas might be a risk factor for penile fractures due to the Christmas spirit related to the intimacy and euphoria of these holly jolly days. PATIENTS AND METHODS: We evaluated the incidence of penile fractures during Christmas and New Year's Eve through the GeRmAn Nationwide inpatient Data (GRAND) from the Research Data Center of the Federal Bureau of Statistics (Wiesbaden, Germany). Furthermore, we assessed the impact of COVID-19 on penile fractures and their seasonality. RESULTS: A total of 3,421 patients with a median, interquartile range (IQR) age of 42 (32-51) years had a penile fracture requiring a hospital stay from 2005 to 2021. In all, 40 (1.2%) penile fractures occurred in 51 days of Christmas (from 24/12 to 26/12 in each year). The daily incidence of penile fractures during Christmas was 0.78 with an incidence rate ratio (IRR) of 1.43 (95% confidence interval [CI] 1.05-1.95, P = 0.02). If every day was like Christmas, 43% more penile fractures would have occurred in Germany from 2005 on. Interestingly, only 28 (0.82%) penile fractures occurred during the New Year's Eve period (31/12 to 02/01 from 2005 to 2021). This resulted in an IRR of 0.98 (95% CI 0.69-1.5, P = 0.98) in the New Year's Eve period. Most patients with penile fractures were admitted to hospital at the weekend (n = 1,322; IRR 1.58, 95% CI 1.48-1.69; P < 0.001). Summer was also associated with more penile fractures (n = 929; IRR 1.11, 95% CI 1.03-1.19; P = 0.008). Both the COVID-19 pandemic (n = 385; IRR 1.06, 95% CI 0.95-1.18, P = 0.29) and its lockdown period (n = 93; IRR 1, 95% CI 0.82-1.23; P = 0.96) did not affect the incidence of penile fractures. CONCLUSION: The incidence of penile fractures displays a seasonality. Last Christmas penile fractures occurred more often. This year to save us from tears, we will NOT do something special (the new Christmas hit of the year).


Asunto(s)
Hospitalización , Pandemias , Humanos , Adulto , Persona de Mediana Edad , Factores de Riesgo , Incidencia , Hospitales
4.
West Afr J Med ; 40(6): 663-665, 2023 Jun 29.
Artículo en Inglés | MEDLINE | ID: mdl-37390503

RESUMEN

Penile fracture is a rare urological emergency typically caused by vigorous sexual intercourse, masturbation, and trauma. Only very few cases with a non-coital etiology or trauma have been reported in the literature. While cases of penile fracture resulting from the manipulation of the erect penis during masturbation have been reported in the Middle East, we report here a rare case of a penile fracture as a result of manipulation of the turgid penis during nocturnal penile tumescence. Following penile manipulation during nocturnal penile tumescence, our patient presented with persistent penile pain, progressive penile swelling, and penile deformity. Immediate surgical management was carried out with excellent outcomes. The diagnosis of the case with the specifics of the intraoperative findings and the surgical procedure are presented in this report. Our goal is to emphasize that non-coital-related penile fractures can occur and should be recognised to prompt early diagnosis and prompt treatment to avoid complications.


La fracture du pénis est une urgence urologique rare, typiquement causée par des rapports sexuels vigoureux, la masturbation et les traumatismes. Seuls quelques cas d'étiologie non coïtale ou de traumatisme ont été rapportés dans la littérature. Alors que des cas de fracture du pénis résultant de la manipulation du pénis en érection pendant la masturbation ont été rapportés au Moyen-Orient, nous rapportons ici un cas rare de fracture du pénis résultant de la manipulation du pénis turgescent pendant la tumescence nocturne du pénis. Suite à la manipulation du pénis pendant la tumescence nocturne, nos patient ont présenté une douleur persistante au niveau du pénis, un gonflement progressif du pénis et une déformation du pénis. Une intervention chirurgicale immédiate a été réalisée avec d'excellents résultats. Le diagnostic de ce cas, ainsi que les détails des résultats peropératoires et de la procédure chirurgicale sont présentés dans ce rapport. Notre objectif est de souligner que les fractures du pénis non liées à l'acte sexuel peuvent se produire et doivent être reconnues pour un diagnostic et un traitement précoces afin d'éviter les complications. Mots-clés: Fracture du pénis, Tumescence nocturne du pénis, Manipulation du pénis, Masturbation.


Asunto(s)
Erección Peniana , Pene , Masculino , Humanos , Pene/cirugía
5.
Curr Urol Rep ; 22(2): 13, 2021 Jan 20.
Artículo en Inglés | MEDLINE | ID: mdl-33471204

RESUMEN

PURPOSE OF REVIEW: To review the current literature on acute management of traumatic penile fracture, with a specific discussion of those injuries following collagenase clostridium histolyticum (CCH) injections for the treatment of Peyronie's disease. RECENT FINDINGS: The immediate repair of traumatic penile fracture injury is associated with significantly better prognosis for long-term sexual health. Corporal disruption following CCH administration has several distinct features, and the trend is to manage these patients conservatively in the absence of urethral injury. Traumatic penile fracture repair continues to have excellent results when performed immediately following injury. The post-CCH treatment setting portends increased difficulty during surgical management and can be successfully managed in most cases by conservative measures.


Asunto(s)
Colagenasa Microbiana/administración & dosificación , Induración Peniana/tratamiento farmacológico , Pene/lesiones , Agentes Urológicos/administración & dosificación , Tratamiento Conservador , Humanos , Inyecciones Intralesiones , Masculino , Colagenasa Microbiana/uso terapéutico , Enfermedades del Pene/tratamiento farmacológico , Enfermedades del Pene/cirugía , Enfermedades del Pene/terapia , Induración Peniana/complicaciones , Pene/cirugía , Rotura/cirugía , Resultado del Tratamiento , Agentes Urológicos/uso terapéutico
6.
Am J Emerg Med ; 44: 184-186, 2021 06.
Artículo en Inglés | MEDLINE | ID: mdl-33041121

RESUMEN

INTRODUCTION: Penile fracture arises as a result of a unilateral or bilateral rupture of the tunica albuginea of the corpus cavernosum. It is a rare condition that requires urgent surgical intervention. In this study, we aimed to determine the effectiveness of surgical treatment in penile fracture and its effect on complications. METHODS: The data of 21 patients who were admitted to the emergency department of our clinic between 2012 and 2019 and underwent emergency surgical repair with the diagnosis of penile fracture were collected retrospectively. The diagnosis of penile fracture was established by anamnesis and physical examination. Age, etiology, duration from trauma to surgery, physical examination findings,length and localization of the tunica albuginea defect, length of hospital stay, and postoperative first-, third- and sixth-month follow-up results were analyzed. Erectile function was evaluated using the International Index of Erectile Function (IIEF-5). Complications such as penile curvature, penile nodule and painful erection were evaluated. RESULTS: The mean age of the patients was 36.8 ± 8.3 years. The most common reason of penile fracture was manually bending the penis for detumescence. All patients underwent surgery. The mean duration from trauma to surgery was 7.6 ± 3.1 h. The mean length of the tunica albuginea defect was 11 ± 2.5 mm. The mean length of hospital stay was 2.5 ± 0.5 days. The mean IIEF-5 scores in the postoperative first, third and sixth months were 20.5 ± 2.6, 22 ± 2.2, 22.1 ± 1.7, respectively. CONCLUSION: Penile fracture is a urological emergency, and timely surgery is an effective treatment method for preventing postoperative complications.


Asunto(s)
Enfermedades del Pene/cirugía , Pene/lesiones , Adulto , Servicio de Urgencia en Hospital , Humanos , Tiempo de Internación/estadística & datos numéricos , Masculino , Erección Peniana , Pene/cirugía , Complicaciones Posoperatorias/prevención & control , Estudios Retrospectivos , Rotura , Tiempo de Tratamiento
7.
Turk J Med Sci ; 51(4): 2193-2197, 2021 08 30.
Artículo en Inglés | MEDLINE | ID: mdl-33862671

RESUMEN

Background/aim: This study assessed the histopathological effects of aloe vera (AV) on penile fractures (PF) formed experimentally in rat model. Materials and methods: Thirty-two Wistar adult male rats (220 to 250 g) were used. The PF model was created experimentally with a number 15 lancet. After the interventions, all of the rats were randomly and equally divided into 4 groups. In the first group, incision was not closed (group C). In the second group, AV was locally applied onto incision without suturing for 3 days (group AV). In the third group, the incision line was closed primarily (group PR). In the last group, AV was applied to primary repair region for 3 days (group PAV). All groups were compared to each other according to presence of fibrosis, inflammation, and hyperemia-bleeding. Results: Hyperemia and bleeding were seen in all groups with varying degrees and the difference between groups was insignificant (p = 1.000). According to inflammation, there was a significant difference between all groups (p = 0.031). No significant inflammation was observed in group AV and therefore, group AV had a better score than group PR (p = 0.026). In group PAV, inflammation was less seen than group PR, however, the difference was insignificant (p = 0.119). According to fibrosis, group AV and group PAV had same fibrosis rates. Fibrosis was observed in 2 (25%) rats in each group. When group PR was compared with group AV and group PAV, there were no significant differences according to cavernosal tissue healing with fibrosis (p = 0.132 and p = 0.132, respectively). Conclusion: Local application of AV onto the PF region without closing with suture decreased inflammation in rats.


Asunto(s)
Aloe/química , Pene/efectos de los fármacos , Pene/lesiones , Cicatrización de Heridas/efectos de los fármacos , Administración Tópica , Animales , Fibrosis , Hiperemia , Inflamación/tratamiento farmacológico , Masculino , Fitoterapia , Ratas , Ratas Wistar , Resultado del Tratamiento
8.
Zhonghua Nan Ke Xue ; 27(1): 39-44, 2021 Jan.
Artículo en Zh | MEDLINE | ID: mdl-34914279

RESUMEN

OBJECTIVE: To investigate the impacts of surgical treatment of penile fracture on the short- and long-term psychological, erectile and urinary functions of the patient. METHODS: Fifty patients with penile fracture underwent surgical treatment in the Emergency Department of our hospital from June 2010 to December 2015. Using the Self-Rating Depression Scale (SDS), Self-Rating Anxiety Scale (SAS), IIEF-5 and IPSS, we evaluated the psychological, erectile and urinary functions of the patients at 1 day, 6 months and 18 months after surgery, and analyzed the relationship between psychological and erectile functions as well as the possible factors affecting erectile function postoperatively. RESULTS: Compared with the baseline, significant increases were observed at 6 months after surgery in the SDS score (30.3 ± 4.1 vs 50.7 ± 6.5, P < 0.01) and SAS score (29.9 ± 5.9 vs 55.4 ± 7.7, P < 0.01) but a remarkable decrease in the IIEF-5 score (22.4 ± 1.3 vs 18.4 ± 2.1, P < 0.01). At 18 months, neither SDS (50.7 ± 10.0) or SAS score (54.1 ± 8.7) showed any statistically significant difference from that at 6 months (P > 0.05), but the IIEF-5 score (21.1 ± 2.2) was markedly lower than the baseline (P < 0.01), though higher than that at 6 months (P < 0.01). The IPSS scores at 6 and 18 months exhibited were not significantly different from that preoperatively (P > 0.05). Both the SDS and SAS scores were evidently higher in the patients with severe than in those with mild ED. The body mass index (BMI) and waiting time for surgery were significantly negatively correlated with short- and long-term erectile function of the patients after surgery. CONCLUSIONS: Patients with penile fracture may have decreased erectile function after surgery, accompanied with anxiety and depression. The risk factors for ED include BMI and waiting-for-surgery time.


Asunto(s)
Erección Peniana , Índice de Masa Corporal , Humanos , Masculino
9.
World J Urol ; 38(2): 287-292, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31123850

RESUMEN

PURPOSE: The introduction of collagenase Clostridium histolyticum (CCH) has revolutionized the treatment of Peyronie's disease. The efficacy of this therapy has been well demonstrated and the safety profile is favorable. However, post-injection complications are poorly characterized and management of these complications lacks standardization. METHODS: This review includes literature published in English and indexed in the PubMed®, Embase® or Google Scholar™ databases. What follows is a synopsis of relevant articles, including original research studies, in an attempt to better define CCH complications and their respective management strategies. RESULTS: Adverse effects of therapy are common but generally self-limiting. Penile pain and edema are expected events, and most patients experience hematologic sequelae (bleeding, hematoma, ecchymosis, etc.). The intervention rate for penile hematoma is low. Penile fracture is a morbid complication of therapy that is rare and may be challenging to diagnose given the frequency with which pronounced bruising and swelling are encountered. Imaging is a useful adjunct in situations of diagnostic uncertainty. Alternative injection protocols have been evaluated to limit the cost and morbidity of CCH therapy. Clinical efficacy of these protocols is promising, but prospective evaluation is lacking. CONCLUSIONS: No standardized protocols exist for management of post-injection complications of CCH therapy. The majority of these complications are managed conservatively, but suspected penile fracture should be carefully evaluated and imaging employed when needed. Future prospective studies of alternative injection protocols are warranted to decrease morbidity while maintaining efficacy.


Asunto(s)
Clostridium histolyticum/enzimología , Manejo de la Enfermedad , Colagenasa Microbiana/administración & dosificación , Induración Peniana/tratamiento farmacológico , Humanos , Inyecciones Intralesiones , Masculino , Pene , Resultado del Tratamiento
10.
BJU Int ; 122(1): 26-28, 2018 07.
Artículo en Inglés | MEDLINE | ID: mdl-29438589

RESUMEN

Male genital emergencies relating to the penis and scrotum are rare and require prompt investigation and surgical intervention. Clinicians are often unfamiliar with the management of these conditions and may not work in a specialist centre with on-site expertise in genitourethral surgery. The aim of these consensus statements is to provide best practice guidance for urological surgeons based in the UK which are developed by an expert consensus. Penile fracture is a rare emergency and in most cases requires prompt exploration and repair to prevent erectile dysfunction and penile curvature.


Asunto(s)
Tratamiento de Urgencia/métodos , Pene/lesiones , Cuidados Posteriores , Urgencias Médicas , Humanos , Masculino , Pene/diagnóstico por imagen , Pene/cirugía , Cuidados Posoperatorios/métodos , Rotura/terapia , Heridas no Penetrantes/diagnóstico por imagen , Heridas no Penetrantes/etiología , Heridas no Penetrantes/terapia
11.
Arch Ital Urol Androl ; 90(2): 143-144, 2018 Jun 30.
Artículo en Inglés | MEDLINE | ID: mdl-29974733

RESUMEN

Penile trauma represents a urological emergency characterized by the breaking of the albuginea tunic. A fast diagnosis and early surgical repair are the best treatments to avoid post-operative sequelae such as curvatures or deformities of the penis. An ultrasound evaluation may not be able to identify the injury in the tunica albuginea due to the edematous swelling of the penis and clots within the tear deteriorate the image contrast and can hide the injury. We here report a case study of successful management via surgical treatment for rupture of the cavernous body diagnosed by contrast-enhanced ultrasound in a young patient with penile trauma.


Asunto(s)
Pene/diagnóstico por imagen , Pene/lesiones , Ultrasonografía/métodos , Adulto , Medios de Contraste , Edema/etiología , Edema/terapia , Servicios Médicos de Urgencia , Humanos , Masculino , Pene/cirugía , Rotura/cirugía , Procedimientos Quirúrgicos Urológicos Masculinos
12.
J Med Ultrasound ; 26(1): 48-51, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-30065514

RESUMEN

Penile fracture is defined as a traumatic rupture of either corpus cavernosum or the tunica albuginea; sometimes it can be both. It may be caused by exotic masturbation acts, sexual intercourse, or other trauma to this area. This can be accompanied by injury to the urethra, which is the cause of hematuria as a symptom for some patients. Typically, diagnosis of penile rupture or fracture depends on clinical examination and history told by the patients. We are stating the importance of medical imaging in the diagnosis of patients with penile fracture by presenting a case of patient suffered from penile fracture after a fall on his penis where it affected the erection of two-third of his penis. In which, the proper diagnosis by imaging studies and taking actions accordingly can save the patients from unnecessary surgeries that indeed increase the bill of the medical care directly and indirectly. Therefore, most patients can be diagnosed cost-effectively and treated surgically without a need to delay surgery, which is often the case if one was to resort to other investigations. Investigations such as retrograde urethrography for suspected urethral injury should only be used when the diagnosis of penile fracture is in doubt.

13.
Toxicol Ind Health ; 31(8): 704-11, 2015 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-23545900

RESUMEN

Penile fracture (PF) is known as a traumatic rupture of the tunica albuginea of corpus cavernosum. In this study, we aimed to investigate the healing influence of topical extra virgin olive oil (EVOO) on PF through evaluating levels of some oxidative stress biomarkers for the first time. Histopathological evaluation was also realized. A total of 18 male Sprague-Dawley albino rats were divided into three groups of six rats each as control group, in PF (alone) group, and PF + EVOO group. Experimental PF was formed via incising from the proximal dorsal side of the penis in the rats of all groups except control. While in PF (alone) group, fracture was formed and the incision was primarily closed, in PF + EVOO group in addition to foregoing processes, EVOO was also administrated topically twice a day for 3 weeks. At the end of the experiment, all rats were killed and penectomy was carried out. While malondialdehyde, myeloperoxidase, lipid hyroperoxide, and total oxidant status significantly (p < 0.05) increased, reduced glutathione and total free sulfhydryl groups markedly (p < 0.05) decreased in PF (alone) group when compared with PF + EVOO group. Levels of these parameters were reversed to nearly normal values by topical EVOO application. Protection by EVOO is further substantiated via the improved histological findings in PF + EVOO group as against degenerative changes in the rats of PF (alone) group. Our data revealed that EVOO has protective effect in penile cavernosal tissue through probably its antioxidant, free radical defusing, anti-inflammatory, and antimicrobial effects.


Asunto(s)
Antioxidantes/farmacología , Aceite de Oliva/uso terapéutico , Estrés Oxidativo/efectos de los fármacos , Enfermedades del Pene/tratamiento farmacológico , Animales , Biomarcadores , Masculino , Aceite de Oliva/administración & dosificación , Enfermedades del Pene/patología , Ratas , Ratas Sprague-Dawley
14.
Emerg Nurse ; 23(6): 16-7, 2015 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-26451939

RESUMEN

Penile fracture is an uncommon injury and requires urgent treatment, therefore emergency nurses should be aware of the signs and symptoms and understand the importance of immediate surgical referral. This article describes the anatomy and physiology of penile erection and the ways in which penile fracture can occur. It also outlines the management of patients and includes a case study of a fracture caused by vigorous masturbation.


Asunto(s)
Pene/lesiones , Coito , Diagnóstico Diferencial , Equimosis/etiología , Equimosis/cirugía , Humanos , Masculino , Masturbación , Erección Peniana , Pene/cirugía , Rotura/diagnóstico , Rotura/cirugía
15.
Andrology ; 12(4): 835-840, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-37691298

RESUMEN

BACKGROUND: Surgical exploration and closure of the tunica albuginea is the recommended treatment for penile fractures. The recovery of sexual function is the main result that surgeons and patients pursue. OBJECTIVE: We sought to evaluate the sexual health effects of a surgically corrected penile fracture. Secondarily, we sought to identify risk factors that may influence long-term sexual function and their effects on genital body image satisfaction. METHODS: A retrospective analysis of patients who underwent surgical correction of penile fractures between 2007 and 2022 in a tertiary center was performed. Lesion characteristics, weeks until the resumption of sexual activity, and post-operative sexual function were recorded. The presence of glans hypoesthesia, penile deformation, penile nodule palpation, and self-satisfaction with body image were assessed. RESULTS: Sixty-nine patients with a mean age of 42.30 ± 12.98 years and a median follow-up of 70 (20-134) months were identified. Sexual intercourse was recorded as a percentage. Penile deformation was the most common complication, appearing in 14.5% of patients, erectile dysfunction in 5.8%, penile nodules in 4.3%, and glans hypoesthesia in 2.9%. The median post-operative International Index of Erectile Function-5 was 24 (21.5-24). Self-satisfaction with body image had a median of 9 and was negatively associated with bilateral lesions and penile deformation. DISCUSSION AND CONCLUSION: Distal fractures could be linked to erectile dysfunction and glans hypoesthesia. Surgical correction of penile fractures shows positive functional and self-reported outcomes, and the potential andrological complications rarely necessitate specific treatment.


Asunto(s)
Disfunción Eréctil , Enfermedades del Pene , Masculino , Humanos , Adulto , Persona de Mediana Edad , Disfunción Eréctil/etiología , Estudios Retrospectivos , Hipoestesia/complicaciones , Pene/cirugía , Satisfacción del Paciente , Resultado del Tratamiento
16.
Cureus ; 16(6): e63440, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-39077247

RESUMEN

A penile fracture results from the rupture of the tunica albuginea due to blunt trauma to an erect penis and is a rare urological emergency. Double penile fractures involving both corpora cavernosa injuries are extremely uncommon. We report the case of a 38-year-old male who experienced acute penile pain, swelling, and a "cracking" sound during sexual intercourse. Examination and ultrasound confirmed bilateral tunica albuginea ruptures and hematoma. The surgical repair involved hematoma evacuation and suturing of the tears. The patient recovered without complications. This case highlights the necessity for prompt recognition and surgical intervention in double penile fractures to prevent long-term complications and ensure optimal recovery.

17.
Int J Surg Case Rep ; 116: 109420, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38394942

RESUMEN

INTRODUCTION AND IMPORTANCE: Penile fracture is a relatively uncommon condition that most commonly results from blunt trauma during sexual intercourse, forced flexion, masturbation, or rolling over. However, other causes are also possible. It is a catastrophic illness to the patient's organic and psychological health. CASE PRESENTATION: We report a case of a 43-year-old male patient who sustained a penile fracture due to the presence of a toothbrush implant. No urethral injury was documented. The patient underwent surgical repair, and one month post-surgery, exhibited no deformity and had a normal sexual and voiding function. CLINICAL DISCUSSION: Penile fracture is most commonly caused by blunt trauma during sexual intercourse. While it has not been documented in the literature, penile implants may increase the incidence of penile fractures. Clinical examination and urethrography confirmed the absence of urethral injury. In cases where a penile fracture is suspected, the only management is surgical exploration. This approach has resulted in the lowest rate of negative long-term sequelae and does not negatively impact the patient's psychological well-being. CONCLUSION: Penile fracture is a rare but serious condition that can result from the presence of an unstandardized implant. It is not close to the incidence of penile fracture for unstandardized prosthesis as even the standardized implant can get fracture when counter to high velocity. To avoid functional and morphological abnormalities, surgical exploration is recommended as the primary course of treatment.

18.
Ir J Med Sci ; 193(2): 917-920, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-37864674

RESUMEN

BACKGROUND: Penile fractures are uncommon urological emergencies which occur when there has been a breach in the tunica albuginea of the corpora cavernosum that may be unilateral and bilateral and can extend to involve the urethra. AIM: To assess the management and outcomes of penile fractures in a single institution in Ireland. METHODS: A retrospective review of the emergency theatre logbooks was performed between 2011 and 2021 to identify patients who had undergone an exploration for a suspected penile fracture. OUTCOMES: Seventeen patients were initially identified on review of theatre logbooks as having an exploration for a suspected penile fracture. Two patients were excluded from the study due to a lack of clinical notes being available. A further 4 patients on chart review were found to not have a penile fracture at exploration. RESULTS: Eleven patients had a confirmed penile fracture intra-operatively, four of whom had an associated urethral injury. Nine (9/11) patients had preserved normal erections post-operatively documented on follow-up; two, however, reported erectile dysfunction requiring phosphodiesterase inhibitors. CLINICAL IMPLICATIONS: Our study supports urgent surgical exploration for penile fractures to ensure good functional outcomes. STRENGTHS AND LIMITATIONS: This is a retrospective review of theatre logbooks to identify patients with a suspected penile fracture. CONCLUSION: The results of our cohort show a good outcome of erectile function following surgical repair of a penile fracture (9/11; 82%). Four patients (4/11; 36%) had a urethral injury diagnosed intra-operatively, one of whom required a formal urethroplasty.


Asunto(s)
Pene , Masculino , Humanos , Rotura/cirugía , Pene/cirugía , Pene/lesiones , Estudios Retrospectivos , Periodo Posoperatorio , Irlanda
19.
Br J Radiol ; 2024 Sep 02.
Artículo en Inglés | MEDLINE | ID: mdl-39221998

RESUMEN

OBJECTIVES: The primary objective is to compare the imaging and surgical findings in a cohort of patients with suspected penile fracture (PF). METHODS: Retrospective cohort study of all patients with suspected PF over an 11-year period at a tertiary referral andrology centre. All dedicated presurgical imaging with ultrasound (US) and MRI was analysed and correlated with intraoperative findings; alternative diagnoses were recorded. RESULTS: 193 patients were included. 104 (54%) had alternative diagnoses to PF including dorsal vein rupture and haematoma. 99 (51%) underwent surgical exploration of which 89 (46%) had PF.US correctly confirmed the presence and marked site of fracture in 92% of cases. MRI was primarily used as a problem-solving tool (13 cases) and demonstrated a more extensive injury than US (12 cases). The reported size of tunical defect on imaging was a median of 7 mm (IQR 4-10) significantly smaller than on exploration, (median 20 mm, IQR 10-30) p < 0.0001. CONCLUSION: US has a high positive predictive value in the confirmation of penile fracture. MRI improves the detection and characterising the extent of injury. Imaging marking informs surgical incision but defect size is under appreciated on all imaging modalities. ADVANCES IN KNOWLEDGE: Penile imaging has a high positive predictive value to not only confirm the diagnosis of PF but to stage the extent of injury and mark the skin, which impacts the surgical technique. Alternative diagnoses to fracture are common and imaging could prevent unnecessary surgical exploration.

20.
Int J Surg Case Rep ; 118: 109623, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38615465

RESUMEN

INTRODUCTION AND IMPORTANCE: Penile fractures, though rare, demand urgent surgical attention due to their potentially severe consequences. This case report illustrates the significance of prompt and comprehensive imaging with surgical exploration in managing a delayed presentation of a double penile fracture. CASE PRESENTATION: A 27-year-old male sustained a penile injury during sleep, presenting to our department 36 h post-trauma. His clinical symptoms included significant penile swelling, deviation, and the characteristic 'eggplant' deformity. Ultrasonography revealed extensive subcutaneous edema and a substantial hematoma at the penile base, with a disruption in the tunica albuginea. Surgical exploration identified two distinct fractures in the corpora cavernosa, which were successfully repaired. The patient experienced a rapid and complication-free recovery, regaining full erectile function within four days. CLINICAL DISCUSSION: This case underlines the anatomical complexity of penile fractures. Despite the delay in seeking medical attention, the outcome was favorable, challenging the notion that immediate surgery is crucial for avoiding long-term complications. The literature suggests that delayed surgery might not significantly impact long-term outcomes, especially in the absence of urethral involvement, a perspective supported by our case findings. CONCLUSION: Penile fracture requires a nuanced approach to diagnosis and treatment. The case demonstrates that while immediate surgical intervention is ideal, delayed repair can also result in positive outcomes under certain conditions. This report contributes to the growing body of evidence suggesting the potential for re-evaluating current clinical guidelines for penile fracture management.

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