Department of Urology, Humanitas Mater Domini, Castellanza-Varese, Italy.
Department of Urology, University Hospitals Leuven, Leuven, Belgium.
Eur Urol Focus. 2018 Jan;4(1):106-110. doi: 10.1016/j.euf.2016.02.012. Epub 2016 Mar 4.
Penile fracture is a rare clinical entity that represents a urologic emergency. It involves traumatic rupture of the tunica albuginea of the corpora cavernosa due to twisting or bending of the penile shaft during erection.
To determine the differences in preoperative diagnostic evaluation patterns and outcomes of penile fracture patients to investigate the impact of surgical delay on functional outcomes.
DESIGN, SETTING, AND PARTICIPANTS: A retrospective analysis was performed using data obtained from 137 patients presenting with penile fracture at seven different European academic medical centers between 1996 and 2013. Age, imaging modalities used, timing of surgical intervention, length of tunica albuginea defect, and surgical technique were recorded. Postoperative erectile function outcomes were assessed with the International Index of Erectile Function (IIEF-5), and the presence of postoperative penile curvature was noted.
The association between timing of surgical intervention and postoperative IIEF-5 results was evaluated with discriminant function analysis.
The median age of the patients was 34.50 yr (interquartile range [IQR]: 28.0-46.5 yr). Of the 137 patients, 82 (59.85%) underwent penile Doppler ultrasound, and 5 patients (3.64%) were evaluated with magnetic resonance imaging. All patients were treated surgically, and the duration between emergency room admission and surgical intervention was 5.0h (IQR: 3.6-8.0h). The median length of tunica albuginea defect was 10mm (IQR: 8-20mm). Postoperative IIEF-5 scores were 21 (IQR: 12-23) and 23 (IQR: 15-24) at the first and third postoperative months, respectively. Discriminant function analysis revealed that if the surgical intervention was performed >8.23hours after emergency room admission, postoperative erectile function was significantly worse (p=0.0051 at first month and p=0.0057 at third month postoperatively).
Our multicenter study showed that delaying surgical intervention results in significantly impaired erectile function. Surgical treatment must be planned as soon as possible to avoid postoperative erectile dysfunction.
We looked at sexual outcomes following the repair of penile fracture in a large European population. We found that outcomes worsened if surgical repair was delayed.
阴茎骨折是一种罕见的临床病症，属于泌尿科急症。它是由于阴茎勃起时阴茎海绵体白膜的扭转或弯曲导致破裂。
确定阴茎骨折患者术前诊断评估模式和结果的差异，以探讨手术延迟对功能结果的影响。
设计、地点和参与者：对 1996 年至 2013 年间欧洲七家学术医疗中心的 137 名阴茎骨折患者的数据进行回顾性分析。记录患者年龄、使用的影像学检查、手术干预时机、白膜缺损长度和手术技术。术后勃起功能采用国际勃起功能指数（IIEF-5）进行评估，并记录术后阴茎弯曲的存在情况。
采用判别函数分析评估手术干预时机与术后 IIEF-5 结果之间的关系。
患者的中位年龄为 34.50 岁（四分位距 [IQR]：28.0-46.5 岁）。137 例患者中，82 例行阴茎多普勒超声检查（59.85%），5 例（3.64%）行磁共振成像检查。所有患者均行手术治疗，从急诊就诊到手术干预的时间为 5.0h（IQR：3.6-8.0h）。白膜缺损的中位长度为 10mm（IQR：8-20mm）。术后 1 个月和 3 个月的 IIEF-5 评分分别为 21（IQR：12-23）和 23（IQR：15-24）。判别函数分析显示，如果急诊就诊后 8.23 小时以上进行手术干预，术后勃起功能明显下降（术后 1 个月时 p=0.0051，术后 3 个月时 p=0.0057）。
我们的多中心研究表明，手术延迟会导致勃起功能显著受损。必须尽快计划手术治疗，以避免术后勃起功能障碍。
我们研究了在欧洲较大人群中阴茎骨折修复后的性功能结果。我们发现，如果手术修复延迟，结果会恶化。
