The presentation and outcomes of penile fracture with associated urethral injury: A systematic literature review
https://doi.org/10.4081/aiua.2023.11082
Accepted: April 7, 2023
Supplementary material: 15
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Purposes: Penile fracture (PF) with associated urethral injury has been described as a rare condition yet a serious urological emergency. We conducted this systematic review to address the current literature concerning the etiology, presentations, intra-operative findings, site of injury, and complications of PF with associated urethral injury, Materials and Methods: The present systematic review was limited to human-based studies published in English language, and reporting clinical data on PF cases with associated urethral injuries. A comprehensive search of the literature was conducted on five electronic databases from their inception to May 2022: Medline via PubMed, Web of Science, Google Scholar, Scopus, and EBSCO host. Results: A total of 15 studies were included encompassing 1671 patients with PF. Out of 1665 patients with PF retrieved from the case series studies, 65 patients had associated urethral injuries giving a point prevalence of 3.9%. The vast majority of the patients had blood on the meatus and hematuria suggestive of urethral injury (57/59; 96.6%). Forty patients had partial urethral disruption and the rest of the patients had a complete rupture. All patients received primary urethroplasty as the main modality of treatment. The median hospital stay was two days and the median duration of transurethral catheterization was 21 days. Five patients (8.5%) developed urethral stricture; other complications included penile curvature (6.7%), palpable fibrosis (6.7%), and erectile dysfunction (3.4%). Conclusions: Urethral injuries are uncommon, but serious findings, in patients with PF. Primary urethroplasty appears to achieve satisfactory outcomes with a low incidence of short and long-term complications.
Mahapatra RS, Kundu AK, Pal DK. Penile Fracture: Our Experience in a Tertiary Care Hospital. World J Mens Health. 2015; 33:95. DOI: https://doi.org/10.5534/wjmh.2015.33.2.95
Eke N. Fracture of the penis. Br J Surg. 2002; 89:555-65. DOI: https://doi.org/10.1046/j.1365-2168.2002.02075.x
El-Sherif AE, Dauleh M, Allowneh N, Vijayan P. Management of Fracture of the Penis in Qatar. Br J Urol. 1991; 68:622-5. DOI: https://doi.org/10.1111/j.1464-410X.1991.tb15427.x
Ateyah A, Mostafa T, Nasser TA, et al. Penile fracture: Surgical repair and late effects on erectile function. J Sex Med. 2008; 5:1496-502. DOI: https://doi.org/10.1111/j.1743-6109.2007.00769.x
Zargooshi J. Sexual function and tunica albuginea wound healing following penile fracture: An 18-year follow-up study of 352 patients from Kermanshah, Iran. J Sex Med. 2009; 6:1141-50. DOI: https://doi.org/10.1111/j.1743-6109.2008.01117.x
Raheem AA, El-Tatawy H, Eissa A, et al. Urinary and sexual functions after surgical treatment of penile fracture concomitant with complete urethral disruption. Arch Ital Urol Androl. 2014; 86:15-9.
Kamdar C, Mooppan UMM, Kim H, Gulmi FA. Penile fracture: Preoperative evaluation and surgical technique for optimal patient outcome. BJU Int. 2008; 102:1640-4. DOI: https://doi.org/10.1111/j.1464-410X.2008.07902.x
Saglam E, Tarhan F, Hamarat MB, et al. Efficacy of magnetic resonance imaging for diagnosis of penile fracture: A controlled study. Investig Clin Urol. 2017; 58:255-60. DOI: https://doi.org/10.4111/icu.2017.58.4.255
Pavan N, Tezzot G, Liguori G, et al. Penile fracture: retrospective analysis of our case history with long-term assessment of the erectile and sexological outcome. Arch Ital Urol Androl. 2014; 86:359-70. DOI: https://doi.org/10.4081/aiua.2014.4.359
Choi MH, Kim B, Ryu JA, et al. MR imaging of acute penile fracture. Radiographics. 2000; 20:1397-405. DOI: https://doi.org/10.1148/radiographics.20.5.g00se051397
Murray KS, Gilbert M, Ricci LR, et al. Penile fracture and magnetic resonance imaging. Int Braz J Urol. 2012; 38:287-8. DOI: https://doi.org/10.1590/S1677-55382012000200019
Rosenstein DI, Alsikafi NF. Diagnosis and Classification of Urethral Injuries. Urol Clin North Am. 2006; 33:73-85. DOI: https://doi.org/10.1016/j.ucl.2005.11.004
Koifman L, Cavalcanti AG, Manes CH, et al. Penile fracture - Experience in 56 cases. Int Braz J Urol. 2003; 29:35-9. DOI: https://doi.org/10.1590/S1677-55382003000100007
Mydlo JH. Surgeon experience with penile fracture. J Urol. 2001; 166:526-9. DOI: https://doi.org/10.1016/S0022-5347(05)65975-7
Gedik A, Kayan D, Yamis S, et al. The diagnosis and treatment of penile fracture: our 19-year experience. Ulus Travma Acil Cerrahi Derg. 2011; 17:57-60. DOI: https://doi.org/10.5505/tjtes.2011.93763
Shaeer O. Methylene blue-guided repair of fractured penis. J Sex Med. 2006; 3:349-54. DOI: https://doi.org/10.1111/j.1743-6109.2005.00155.x
Higgins JPT, Thomas J, Chandler J, et al. Cochrane handbook for systematic reviews of interventions. Cochrane Handbook for Systematic Reviews of Interventions. 2019, pp 1-694. DOI: https://doi.org/10.1002/9781119536604
Stroup DF, Berlin JA, Morton SC, et al. Meta-analysis of Observational Studies in EpidemiologyA Proposal for Reporting. JAMA. 2000; 283:2008-12. DOI: https://doi.org/10.1001/jama.283.15.2008
Murad MH, Sultan S, Haffar S, Bazerbachi F. Methodological quality and synthesis of case series and case reports. BMJ Evid Bas Med. 2018; 23:60-3. DOI: https://doi.org/10.1136/bmjebm-2017-110853
Amit A, Arun K, Bharat B, et al. Penile fracture and associated urethral injury: Experience at a tertiary care hospital. J Can Urol Assoc. 2013; 7:E168-70. DOI: https://doi.org/10.5489/cuaj.475
Raheem AA, El-Tatawy H, Eissa A, et al. Urinary and sexual functions after surgical treatment of penile fracture concomitant with complete urethral disruption. Arch Ital Urol Androl 2014; 86:15-9. DOI: https://doi.org/10.4081/aiua.2014.1.15
Derouiche A, Belhaj K, Hentati H, et al. Management of penile fractures complicated by urethral rupture. Int J Impot Res. 2008; 20:111-4. DOI: https://doi.org/10.1038/sj.ijir.3901599
Ibrahiem EHI, El-Tholoth HS, Mohsen T, et al. Penile fracture: long-term outcome of immediate surgical intervention. Urology. 2010; 75:108-11. DOI: https://doi.org/10.1016/j.urology.2009.08.057
Ouanes Y, Saadi MH, Haj Alouene H, et al. Sexual Function Outcomes After Surgical Treatment of Penile Fracture. Sex Med. 2021; 9:100353. DOI: https://doi.org/10.1016/j.esxm.2021.100353
Tang Z, Yang L, Wei Q, et al. Management and outcomes of penile fracture: a retrospective analysis of 62 cases with long-term assessment. Asian J Androl. 2018; 20:412. DOI: https://doi.org/10.4103/aja.aja_36_17
Barros R, Silva MIS, Antonucci V, et al. Primary urethral reconstruction results in penile fracture. Ann R Coll Surg Engl. 2018; 100:21-5. DOI: https://doi.org/10.1308/rcsann.2017.0098
Kasaraneni P, Mylarappa P, Gowda RD, et al. Penile fracture with urethral injury: Our experience in a tertiary care hospital. Arch Ital Urol Androl 2019; 90:283-7. DOI: https://doi.org/10.4081/aiua.2018.4.283
Hoag NA, Hennesse K, So A. Penile fracture with bilateral corporeal rupture and complete urethral disruption: case report and literature review. Can Urol Assoc J. 2011; 5:E23. DOI: https://doi.org/10.5489/cuaj.10055
Jagodic K, Erklavec M, Bizjak I, et al. A case of penile fracture with complete urethral disruption during sexual intercourse: a case report. J Med Case Rep. 2007; 1:14. DOI: https://doi.org/10.1186/1752-1947-1-14
Garofalo M, Bianchi L, Gentile G, et al. Sex-related penile fracture with complete urethral rupture: A case report and review of the literature. Arch Ital Urol Androl 2015; 87:260-1. DOI: https://doi.org/10.4081/aiua.2015.3.260
Ge G, Wang H, Chen Y, et al. Complete urethral injury in the penile fracture: a case report and literature review. Transl Androl Urol. 2021; 10:969. DOI: https://doi.org/10.21037/tau-20-1155
Boncher NA, Vricella GJ, Jankowski JT, et al. Penile Fracture with Associated Urethral Rupture. Case Rep Med. 2010; 2010:791948. DOI: https://doi.org/10.1155/2010/791948
Hughes S, Elbaroni W, O’donoghue J, Williams M. Atypical presentation of a vertical penile fracture. BMJ Case Reports CP. 2021; 14:e243353. DOI: https://doi.org/10.1136/bcr-2021-243353
Mercado-Olivares F, Antonio Grandez-Urbina J, Farfan-Daza G, et al. Case Report: Double penile fracture. F1000Research. 2018; 7. F1000Res. 2018; 7:1828. DOI: https://doi.org/10.12688/f1000research.16452.1
Zargooshi J. Penile fracture in Kermanshah, Iran: report of 172 cases. J Urol. 2000; 164:364-6. DOI: https://doi.org/10.1016/S0022-5347(05)67361-2
Fergany AF, Angermeier KW, Montague DK. Review of Cleveland Clinic experience with penile fracture. Urology. 1999; 54:352-5. DOI: https://doi.org/10.1016/S0090-4295(99)00115-6
Bitker MO, Belin J, Jardin A, Chatelain C. “Faux pas du coit” with associated rupture of corpora cavernosa and urethra. Urology. 1988; 32:447-8. DOI: https://doi.org/10.1016/0090-4295(88)90423-2
Agarwal MM, Singh SK, Sharma DK, et al. Fracture of the penis: a radiological or clinical diagnosis? A case series and literature review. Can J Urol. 2009; 16:4568-75.
Mydlo JH, Hayyeri M, Macchia RJ. Urethrography and cavernosography imaging in a small series of penile fractures: A comparison with surgical findings. Urology. 1998; 51:616-9. DOI: https://doi.org/10.1016/S0090-4295(97)00701-2
Copyright (c) 2023 the Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
Downloads
Citations
