11/21/2023 0 Comments Surgical treatment for penile fractureThe reason I love working with a group like TURNS is the ability to use our collective knowledge to help improve patient care. The patient’s penis was repaired and was recently seen and found to be functioning normally. Old blood, or hematoma, was drained and large defect was seen:įigure: Small incision in the penis with drainage of old blood reveals a large tear in the tunica albuginea identified by the white arrow. The patient was taken to the operating room where a small incision was made. There was debate amongst the group but the general consensus is that surgical exploration and repair was reasonable. I was able to get a real time opinion from experts located across the country. Within five minutes, two members already weighed in. ![]() While talking to the patient in the middle of clinic, I emailed the TURNS group to get their opinions on this delayed repair. Not sure if surgery would make a difference, I reached out to my colleagues in TURNS. The longest delayed fracture I had personally repaired was around seven days. He wasn’t getting better and wanted a second opinion. This particular patient presented nearly three weeks after injury when he was told to just watch his injury. This happens for a variety of reasons but the most common are delayed presentation due to embarrassment and the time it takes to be evaluated by a urologist for repair. Many fractures are repaired a few days after they occur. The penis can be conservatively watched but studies show these patients will generally get worse erectile dysfunction and penile curvature when compared to those having surgery. The most effective treatment for penile fracture is a surgical repair at the time of injury. When this layer is torn the patient will feel a painful pop, loses their erection, and develops severe bruising. The tunica albuginea is a tough leathery layer of the penis that traps blood inside, resulting in an erection. The downward force of the female pelvis bends the penis at a severe angle and causes the tunica albuginea to rupture. The most common mechanism of injury is when the female partner is on top and the penis slips out of the vagina. Penile fractures are uncommon injuries that are often a result of sexual intercourse. I gave her instructions to get him in the very next day so we could investigate the matter further. My secretary, who is trained to spot unique requests brought it to my attention. ![]() Penile fracture is one of a handful of urgent cases in urology. Despite being delivered in the routine way, this was no ordinary consult. ![]() The referral was sent to the office via the FAX machine. The other day I received a request to evaluate a man with a penile fracture.
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