FRACTURE OF PENIS

Dear Editor,

I would like to share my experience of treating a rare case of fracture penis with injury to the erectile tissue without associated urethral injury. Mechanism of injury in this patient being self inflicted [1] in order to relieve prolonged erection. Fracture penis is actually a misnomer, as the organ lacks bony support. [2] the tunica albuginea is thinned out to 0.5 mm in an erect organ, and thus more prone to injury. [3]. Forcible bending of the erect organ most commonly during aggressive sexual activity, ruptures this membrane by a sudden ’pop’ or a snap or a crackling sound that has led this to be termed a fracture.[4].

Present case was a 21 yrs old unmarried serving soldier who reported to hospital with severe pain, swelling and deformity of penis. He gave history of forcible downward bending of the erect organ. Immediately it was followed by a snap associated with severe pain, swelling and flaccidity of penis. Patient reported 24 hrs after the injury and passed urine after injury. Local examination revealed swollen, demuniscent, deformed penis, tender to touch and deviated to the left side. It was managed by exploration and evacuation of subcutaneous haematoma, repair of rent in tunica albuginea and corpus cavernosum with 30 prolene interrupted sutures. Postoperative period was uneventful, managed with antibiotics and analgesics. Reviewed after one month, he had optimal erection with no residual deformity.

Some authors advocate conservative management[5]. But the prolonged hospitalization and a higher rate of complications have prompted the universal acceptance of an early and prompt surgical intervention.