Sexual Function Outcomes After Surgical Treatment of Penile Fracture. Issue 3 (29th May 2021) - Ouanes, Yassine
Abstract: Introduction: Penile fracture is a urologic emergency and is defined as the rupture of the tunica albuginea of the cavernous body in erection. Aim: Our study aims to evaluate patients with penile fracture and to identify the factors that may influence the sexual function after surgical repair. Methods: A total of 138 patients who were diagnosed with penile fracture between January, 1999 and December, 2018 were reviewed. Clinical features, perioperative assessment, time from injury to surgery, tunica defect properties, and presence of urethral injury were assessed. Main Outcome Measures: Sexual function was evaluated by three parameters six months after surgical repair: International Index of Erectile Function-5 (IIEF-5) questionnaire, penile curvature and the presence of a painful intercourse. All factors that could potentially influence these parameters were analyzed. Results: The mean age was 31.2 years (19-55). Presentation delay ranged from 1 to 5 days (mean = 16.8 hours) while surgery delay was 14.3 hours ().The most common cause of penile fracture in our patients was forcefully bending of the erect penis to achieve detumescence in 62 cases (44.9%). On multivariate analysis, we found that the presentation delay and the fracture site located in the proximal shaft of the penis showed significant difference in the occurrence of postoperative ED ( P = 0.03 and P = 0.015 respectively). Presentation delay, elective incision and tuncial leak located in the proximal shaft ( P = 0.045; P = 0.018 and P = 0.022 respectively) were associated with higher penis curvature. Conclusion: Immediate surgical repair and circumferential degloving incision for tunical leaks located in the proximal shaft of the penis are recommended in order to decrease the incidence of ED after surgical repair of penile fractures.