Zhu Jun, Tang Yuan, Zhu Sainan, Kang Jianming, Song Weidong, Cui Wanshou, Yuan Yiming, Zhang Zhichao, Peng Jing
Andrology Center, Peking University First Hospital, Beijing (100034), China. No. 8 Xishiku St, Xicheng District, Beijing, 100034, China.
Department of Urology, Peking University First Hospital, No. 8 Xishiku St, Xicheng District, Beijing, 100034, China.
Heliyon. 2024 Sep 10;10(18):e37260. doi: 10.1016/j.heliyon.2024.e37260. eCollection 2024 Sep 30.
Penile fracture is an uncommon urological emergency resulting from tunica albuginea rupture during penile erection. It is a rare condition requiring urgent surgery. Despite immediate surgical repair, the patients' erectile functions may still be impacted by penile fracture. This study aims to investigate the efficacy of surgical repair in penile fractures and its impact on erectile function.
Our cohort was composed of patients diagnosed with penile fractures and received surgical repair from September 2014 to August 2022 in Peking University First Hospital. Penile color Doppler ultrasound confirmed the diagnosis. Surgical exploration was conducted, and postoperative complications were evaluated during follow-up. Erectile function was assessed using the International Index of Erectile Function-5 (IIEF-5) score. Univariate analysis was conducted employing the chi-square test, -test, and Mann-Whitney test to identify factors that may impact postoperative erectile function. Furthermore, multivariate analysis was conducted using logistic regression and linear regression to determine the independent risk factors influencing postoperative erectile function.
A total of 58 patients were enrolled in our study. The majority of injuries (69.0 %, 40/58) resulted from vigorous sexual intercourse. Most of the patients (69.0 %, 40/58) presented within 24 h. Sixteen patients (27.6 %) presented with concomitant urethral injury. The median size of the tunical tear was 1.5 (IQR, 1.0-2.0) cm. Presentation delay correlated significantly with the difference in IIEF-5 score before and after surgery, with corresponding p values of 0.028. Urethral injury correlated significantly with postoperative erectile dysfunction (ED), postoperative IIEF-5 score, and the difference in IIEF-5 score before and after surgery, with corresponding p values of 0.002, 0.004, and 0.002, respectively.
To conclude, surgical repair of penile fracture provides good functional results with few morbidities and urethral injury may adversely affect postoperative erectile function after penile fracture repair.
阴茎骨折是一种罕见的泌尿外科急症，由阴茎勃起时白膜破裂引起。这是一种需要紧急手术的罕见病症。尽管进行了即时手术修复，但阴茎骨折仍可能影响患者的勃起功能。本研究旨在探讨阴茎骨折手术修复的疗效及其对勃起功能的影响。
我们的队列由2014年9月至2022年8月在北京大学第一医院被诊断为阴茎骨折并接受手术修复的患者组成。阴茎彩色多普勒超声确诊。进行手术探查，并在随访期间评估术后并发症。使用国际勃起功能指数-5（IIEF-5）评分评估勃起功能。采用卡方检验、t检验和曼-惠特尼检验进行单因素分析，以确定可能影响术后勃起功能的因素。此外，使用逻辑回归和线性回归进行多因素分析，以确定影响术后勃起功能的独立危险因素。
我们的研究共纳入58例患者。大多数损伤（69.0%，40/58）是由剧烈性交引起的。大多数患者（69.0%，40/58）在24小时内就诊。16例患者（27.6%）伴有尿道损伤。白膜撕裂的中位大小为1.5（IQR，1.0-2.0）厘米。就诊延迟与手术前后IIEF-5评分的差异显著相关，相应的p值为0.028。尿道损伤与术后勃起功能障碍（ED）、术后IIEF-5评分以及手术前后IIEF-5评分的差异显著相关，相应的p值分别为0.002、0.004和0.002。
总之，阴茎骨折的手术修复能带来良好的功能结果，并发症较少，且尿道损伤可能对阴茎骨折修复后的术后勃起功能产生不利影响。
