PENILE FRACTURE : ANALYSIS OF A RETROSPECTIVE SERIES IN THE UROLOGY DEPARTMENT OF FRIENDSHIP HOSPITAL IN NOUAKCHOTT

Medecine

Fracture of the penis is a rupture of the tunica albuginea of the corpora cavernosa. It results from trauma to the erect penis, most often during sexual intercourse or masturbation. It is considered a relatively rare urological emergency. Objective : Our study aimed to investigate the epidemiological, clinical, and therapeutic aspects of penile fracture in the urology department of the Friendship Hospital in Nouakchott (Mauritania). Material and methods : This is a retrospective, descriptive, and analytical single-center study on penile fractures, based on data collected from the hospitalization records of the urology department at the Friendship Hospital in Nouakchott (Mauritania). The study covered a 9-year period, from January 1, 2012, to December 31, 2019. Results : During our study period, we recorded 10 cases of penile fracture, corresponding to an incidence of 1.1 cases per year. The average age of the patients was 34 years, with extremes ranging from 30 to 56 years. The most common reason for consultation was the classic triad: penile pain, swelling, and the patient hearing a cracking sound at the time of trauma—reported by all patients. Physical examination revealed, in 9 out of 10 cases, a hematoma and a swollen penis with deviation, giving the characteristic “eggplant deformity” appearance. Urethral bleeding was observed in only one patient. No additional diagnostic tests were required. All patients underwent emergency surgery. Surgical management consisted of exploration, evacuation of the subcutaneous hematoma, and suturing of the tunica albuginea of the corpora cavernosa. One case of urethral rupture was also identified and managed by suturing the urethra and placing a Foley catheter. The leading cause was forced manipulation of the penis. In our series, seven patients regained normal erectile function, two developed erectile dysfunction, and one patient had scar fibrosis causing a mild penile curvature, which did not interfere with sexual intercourse. No urethral strictures were reported. Conclusion : Penile fracture is a relatively rare urological emergency. It primarily affects sexually active adult men and occurs when the penis is erect. The diagnosis is generally straightforward and based mainly on clinical findings. It is important to look for an associated contusion of the corpus spongiosum, with or without urethral rupture. In nearly all cases, treatment is surgical and involves evacuating the subcutaneous hematoma and suturing the tunica albuginea of the corpora cavernosa.

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