Even though the penis is not a bone, there is such a condition called penis fracture.
A fracture of the penis is a relatively rare disorder, defined as the rupture of the tunica albuginea due to trauma to the erect penis.
Penis fractures normally take place when the engorged penile corpora are pressed to buckle and practically “pop” under the pressure of a blunt sexual injury.
Patients normally have immediate detumescence, severe pain, and swelling as a result of the injury.
Prompt surgical exploration and corporal repair is the most effective treatment.
Vigorous vaginal intercourse and intensive penile masturbation are the most frequent causes.
Penis fracture normally happens from a bending injury during vigorous sexual intercourse, mostly when the penis slips out of the vagina.
In the Western world the most frequent cause, about 30%-50% of cases, is over strenuous sexual intercourse.
Of those, woman-on-top positions leading to impact against the female pelvis or perineum and bending laterally are most frequent.
In Middle East countries the frequent cause is physical handling of the penis to stop an erection.
Taqaandan, which comes from a Kurdish word meaning to click, requires bending the top part of the erect penis while holding the lower part of the shaft in place, until a click is heard and felt.
Most injuries that occur from masturbation come from powerfully reducing an erection without care and fracturing it.
Infrequently it may happen while turning over in bed, forced bending, or rapidly removing or applying clothing when the penis is erect.
In flaccid state it permits considerable degree of abnormality without any injury to the vital structures but in erected state it is susceptible to blunt injury.
Predisposing factors are excessive force at coitus or masturbation, fibrosclerosis of the tunica albuginea and chronic urethritis.
While the penis alters from a flaccid state to an erect state, the thick tunica albuginea becomes very thin from 2 mm to 0.25-0.5 mm.
The tunica albuginea thins, stiffens, and loses elasticity and is easily fracturable.
Penis fracture is linked with urethral interference, and needs repair
A cracking or popping sound, considerable pain, swelling, instant loss of erection leading to flaccidity, and skin hematoma of various sizes are often linked with the sexual event.
Patients complain of a traumatic bending of the erect penis, often with a cracking noise.
Normally, a sudden detumenescense happens and a massive penile hematoma forms.
A deficiency in the tunica albuginea may be palpable
The gross appearance of a fractured penis is often present as an “eggplant deformity,” the combination of localized penile swelling, discoloration, and deviation toward the opposite side of the fracture.
The diagnosis of “penis fracture” specifically indicates a rupture of the corpus cavernosum induced by blunt trauma to the erect penis.
Retrograde urethrography is advised in any case of suspected penis fracture that manifests with urinating difficulty, hematuria, or blood at the meatus
Ultrasound should be considered as the initial imaging method, and MRI can be helpful in cases that ultrasound does not depict any tear
Ice packs, Foley catheterization, and anti-inflammatory medicines were regarded as the early care for penis fractures
Proper surgical repair of penis fractures needs evacuation of the hematoma, recognition of the tunica injury, local corpora debridement, closure of the tunica lacerations, and ligation of any disrupted vasculature.
Besides being the most cosmetic incision, distal degloving readily permits exposure to the entire tunica bilaterally, allowing diagnosis and repair of co-existing urethral and contra-lateral injuries.
TABLE OF CONTENT
Chapter 1 Penis Fracture
Chapter 2 Causes
Chapter 3 Symptoms
Chapter 4 Diagnosis
Chapter 5 Treatment
Chapter 6 Prognosis
Chapter 7 Penis Cancer
Chapter 8 Peyronie Disease