Penile fracture

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What is it about ?

A penile fracture is a rupture of the ‘tunic’ (layer of connective tissue) that surrounds the corpora cavernosa inside the penis. The penis is made up of 3 cavernous bodies. The penis becomes erect when these become gorged with blood. Two of these corpora cavernosa are enveloped in a strong layer of connective tissue, which keeps the blood in the corpora cavernosa. If this connective tissue layer ruptures, blood flows from the corpora cavernosa to other parts of the penis. The erection goes away and the penis takes on a blue-purple color.

The most common cause of penile fracture is twisting of the penis during sex. The riskiest position is where the woman is on top of the man at the time of penetration. Other possible causes are overly forceful masturbation or simply rolling over in bed. Penile fractures in the absence of an erection are very rare.

What is its frequency?

Fracture of the penis is very rare. Less serious penile lesions, with contusion but no real fracture, are more common.

How to recognize it?

The rupture of connective tissue most often causes a cracking noise. Then the erection instantly disappears and severe pain appears, accompanied by a blue-purple coloration and swelling of the penis. Sometimes the penis may have a deformity (curvature).

In rare cases, the bill is also accompanied by a lesion in the urethra. You then experience difficulty urinating and you have to blood in urine.

How is the diagnosis made?

The doctor will ask you questions, including about the sudden loss of an erection, the cracking sound, the presence of blood in urine, the difficulty urinating, …

He will then examine the penis and assess it for swelling, bruising and possible curvature. If the diagnosis is clear after discussion and physical examination, further testing is not necessary.

If the doctor has doubts about the diagnosis, he will offer you a ultrasound, a CT scan or an MRI (magnetic resonance imaging).

What can you do ?

A penile fracture is an emergency: you must see a doctor as soon as possible. After confirmation of the diagnosis, the general practitioner will refer you to an emergency department or a urologist. Due to the embarrassing nature of the injury, many men often delay seeking medical attention. However, urgent medical help is essential and there is nothing to be ashamed of.

What can your doctor do?

In the event of a penile fracture with torsion, a surgical intervention is urgently required. The urologist will suture the tear in the connective tissue layer that surrounds the corpora cavernosa.

After the operation, most men return to normal sexuality.

Want to know more?

Source

Foreign clinical practice guide ‘Penisfractuur’ (2017), updated on 04.09.2017 and adapted to the Belgian context on 19.01.2019 – ebpracticenet

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