title: Penile fractures: immediate surgical approach with a midline ventral incision.
abstract: OBJECTIVE
  To present our experience with immediate surgical treatment of penile fractures, using a midline ventral incision, as the choice of either immediate surgical or conservative treatment in penile fractures, as well as the type of surgical incision, remains controversial.
  
  
  METHODS
  In a period of 5 years (2002-2006) eight patients were treated in our department for a penile fracture. The diagnosis was established by a history and clinical examination. In six patients ultrasonography before surgery located the fracture in the right corpus cavernosum, distally from the penoscrotal junction. All patients had immediate surgery using a midline ventral incision and were followed for a mean of 1 year.
  
  
  RESULTS
  All patients presented with a penile haematoma, while five and two had concomitant scrotal and perineal haematomas, respectively. Penile urethral rupture was associated with corporal cavernosal rupture in one patient. In all patients a 5-cm midline ventral incision was made at the penile raphe. There was unilateral rupture of the corpus cavernosum in seven patients and bilateral rupture with concomitant urethral rupture in one. The fascial defect was sutured in all patients and an end-to-end anastomosis made if there was urethral rupture. The early and late periods after surgery were uneventful. Erectile function was unaffected during the follow-up.
  
  
  CONCLUSIONS
  Immediate intervention for penile fractures, using a midline ventral incision, achieves good early and late results. Our technique has the advantage of direct access to both corpora cavernosa and the anterior urethra, with a minimal skin incision.
authors.affiliation: 2nd Department of Urology, Athens Medical School, Sismanoglio Hospital, Athens, Greece. evmazaris@yahoo.gr
authors.forename: Evangelos M
authors.initials: EM
authors.lastname: Mazaris
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Livadas
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Chalikopoulos
authors.forename: Apostolïs
authors.initials: A
authors.lastname: Bisas
authors.forename: Charalambos
authors.initials: C
authors.lastname: Deliveliotis
authors.forename: Andreas
authors.initials: A
authors.lastname: Skolarikos
mesh_terms: D000328:Adult; D006801:Humans; D008297:Male; D008875:Middle Aged; D010413:Penis / Q000293:injuries / Q000601:surgery*; D012189:Retrospective Studies; D012421:Rupture / Q000601:surgery; D016896:Treatment Outcome; D014521:Urethra / Q000293:injuries / Q000601:surgery*; D013521:Urologic Surgical Procedures, Male / Q000379:methods*