Agrawal Amit, Raj Rankeen
Senior Advisor (Surgery) & Urologist, Command Hospital (Western Command), Chandimandir, Panchkula, Haryana, India.
Classified Specialist (Surgery), 159 General Hospital, C/O 56 APO, India.
Med J Armed Forces India. 2024 Dec;80(Suppl 1):S1-S6. doi: 10.1016/j.mjafi.2022.04.002. Epub 2022 Jun 10.
Fracture penis is an uncommon urological emergency, which often results from sexual trauma. Diagnosis remains clinical, and early surgical management is advocated. However, the timing of the repair may have a bearing on the outcomes. Herein, we share our experience of 17 such cases and compare the complications and the sexual function in relation to the timing of the surgery.
The records of all patients with a penile fracture who had presented to our hospital between 1st Mar 2015 and 28th Feb 2021 were reviewed. All patients were managed surgically. The patients were divided into three groups based on the time elapsed between the injury and the surgery. All patients were followed up for 6 months and the development of complications was recorded. The sexual function was assessed with International Index of Erectile Function (IIEF) at the end of 6 months.
A total of 17 patients were included in the study. Coital trauma was the most common cause, followed by masturbation. 15 out of the 17 patients were operated on within 48 h of the injury. There were no long-term complications except for one patient having a palpable painless nodule at the site of the repair. At 6 months follow-up all patients who had an immediate surgical repair on presentation, had a normal sexual function, and there was no difference between those who presented early or after 48 h of injury.
Immediate surgical intervention should be the treatment of choice for all patients with a penile fracture, even if they present late, to prevent complications and erectile dysfunction.
阴茎骨折是一种罕见的泌尿外科急症,通常由性创伤导致。诊断仍依靠临床判断,提倡早期手术治疗。然而,修复时机可能会影响治疗结果。在此,我们分享17例此类病例的经验,并比较手术时机与并发症及性功能之间的关系。
回顾了2015年3月1日至2021年2月28日期间在我院就诊的所有阴茎骨折患者的病历。所有患者均接受手术治疗。根据受伤与手术之间的时间间隔将患者分为三组。所有患者均随访6个月,并记录并发症的发生情况。在6个月末,使用国际勃起功能指数(IIEF)评估性功能。
本研究共纳入17例患者。性交创伤是最常见的原因,其次是手淫。17例患者中有15例在受伤后48小时内接受了手术。除1例患者在修复部位可触及无痛结节外,无长期并发症。在6个月的随访中,所有就诊时立即接受手术修复的患者性功能均正常,受伤后早期就诊和受伤后48小时后就诊的患者之间没有差异。
对于所有阴茎骨折患者,即使就诊较晚,立即进行手术干预也应作为首选治疗方法,以预防并发症和勃起功能障碍。