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Penile fracture: Retrospective analysis of our case history with long-term assessment of the erectile and sexological outcome

Nicola Pavan, Giorgia Tezzot, Giovanni Liguori, Renata Napoli, Paolo Umari, Michele Rizzo, Giovanni Chiriacò, Gaetano Chiapparrone, Francesca Vedovo, Michele Bertolotto, Carlo Trombetta
  • Nicola Pavan
    Urology Department, Cattinara Hospital, University of Trieste, Italy | nicpavan@gmail.com
  • Giorgia Tezzot
    Urology Department, Cattinara Hospital, University of Trieste, Italy
  • Giovanni Liguori
    Urology Department, Cattinara Hospital, University of Trieste, Italy
  • Renata Napoli
    Urology Department, Cattinara Hospital, University of Trieste, Italy
  • Paolo Umari
    Urology Department, Cattinara Hospital, University of Trieste, Italy
  • Michele Rizzo
    Urology Department, Cattinara Hospital, University of Trieste, Italy
  • Giovanni Chiriacò
    Urology Department, Cattinara Hospital, University of Trieste, Italy
  • Gaetano Chiapparrone
    Urology Department, Cattinara Hospital, University of Trieste, Italy
  • Francesca Vedovo
    Urology Department, Cattinara Hospital, University of Trieste, Italy
  • Michele Bertolotto
    Radiology Department, Cattinara Hospital, University of Trieste, Italy
  • Carlo Trombetta
    Urology Department, Cattinara Hospital, University of Trieste, Italy

Abstract

Objectives: To review the cases of patients with suspected penile fracture and asses erectile and sexological outcomes. Materials and methods: from 1987 to 2013 presented to the Urology Clinic of Trieste and at the AIED of Pordenone a total of 41 cases that were divided into two groups according to the timing of treatment: 18 patients with anamnestic diagnosis of penile fracture treated nonimmediately and 23 patients treated immediately after the trauma. For all patients we evaluated the type of treatment adopted, the occurrence of complications and reoperations and the follow-up. The erectile function was also evaluated through the IIEF, as well as the psychological impact of the trauma on social and sex life, using a psycho- sexological questionnaire. Results: Among patients treated immediately after the trauma 14 were subjected to surgery. About a year after surgery, penile curvature was reported in 1 patient, pain in 3 patients, urinary disorders in 1 patient, while none reported erectile dysfunction (ED). Out of these, only 3 patients underwent reoperation. Among those treated conservatively 1 patient reported curvature, 1 patient reported pain and none reported ED. Among patients who were admitted at a later date, 14 reported curvature and 4 reported pain whereas urinary disorders were reported in 1 and ED in 4 patients. From a psychological point of view, the trauma caused in most cases a fear of new trauma and of repercussions on erectile function and sensitivity. Conclusions: The diagnosis is mainly clinical; however, radiological investigation is essential to confirm the diagnosis, assess the site and extent of the trauma and possible urethral involvement, so as to plan the most appropriate treatment. In addition, immediate treatment leads to better long-term results, with a lower incidence of ED and penile curvature. Psychologically, penile trauma intensifies the fear of reoccurrence; it decreases, however, with the passage of time.

Keywords

Penile fracture; Outcomes; Penile surgery; Penile ultrasound; Erectile deficiency

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Submitted: 2015-01-23 15:54:09
Published: 2014-12-30 00:00:00
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Copyright (c) 2014 Nicola Pavan, Giorgia Tezzot, Giovanni Liguori, Renata Napoli, Paolo Umari, Michele Rizzo, Giovanni Chiriacò, Gaetano Chiapparrone, Francesca Vedovo, Michele Bertolotto, Carlo Trombetta

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