False penile fracture: value of different diagnostic approaches and long-term outcome of conservative and surgical management.
OBJECTIVE
We determined the value of clinical and radiological findings in diagnosis of false penile fracture. Also, the long-term outcome of conservative and surgical treatment of such patients was evaluated.


METHODS
Seventeen patients with false penile fracture were treated conservatively (3 patients) and surgically (14 patients) at our center. Medical records were retrospectively reviewed for etiology, symptoms, signs of physical examination, and information on findings of surgical exploration. Data on erectile function and penile sequelae were obtained during follow-up using the Sexual Health Inventory for Men (SHIM) questionnaire and local examination.


RESULTS
The most common cause of false penile fracture is sexual intercourse (76.5%). False fracture was suspected in 3 patients who presented with small hematoma and slow post-trauma detumescence; intact tunicas were diagnosed by magnetic resonance imaging (MRI) in all of them and were managed conservatively. Surgical penile exploration was performed in 14 cases, in whom preoperative ultrasound was done in 6, and it was false positive for presence of tunical tear in 50%. Exploration revealed nonspecific dartos bleeding in 9 cases and avulsed superficial dorsal vein in 5. Long-term follow-up (mean=93 months) was available for 16 patients, among whom there was no complications.


CONCLUSIONS
In most cases, false penile fracture is indistinguishable from true penile fracture either clinically or radiologically. In atypical cases, MRI seems to be a promising modality for diagnosis of such patients. The long-term outcome of conservative and surgical treatment is excellent.
El-Assmy
Ahmed
A
Department of Urology, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt. a_assmy@yahoo.com
El-Tholoth
Hossam S
HS
Abou-El-Ghar
Mohamed E
ME
Mohsen
Tarek
T
Ibrahiem
El Housseiny I
el HI
D000328:Adult; D000700:Analgesics / Q000627:therapeutic use; D001458:Bandages; D015331:Cohort Studies; D017679:Cryotherapy; D003937:Diagnosis, Differential; D004322:Drainage / Q000379:methods; D007172:Erectile Dysfunction / Q000517:prevention & control; D005189:False Positive Reactions; D005500:Follow-Up Studies; D006406:Hematoma / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010409:Penile Diseases / Q000175:diagnosis* / Q000628:therapy*; D010413:Penis / Q000293:injuries* / Q000473:pathology* / Q000601:surgery; D020127:Recovery of Function; D012189:Retrospective Studies; D018570:Risk Assessment; D016896:Treatment Outcome; D013521:Urologic Surgical Procedures, Male / Q000379:methods; D055815:Young Adult
D000700:Analgesics