Penile fracture: diagnosis, treatment and outcomes of 150 patients.
OBJECTIVE
To report the diagnosis, treatment options, and outcomes of 150 patients with suspicion of penile fracture.


METHODS
We analyzed 150 patients with clinically suspected penile fracture (PF). The patients were divided into two groups: group 1 (G1) with low suspicion of penile fracture (n = 25), and group 2 (G2) with high suspicion of penile fracture (n = 125). Complementary image methods were conducted on 59 patients (39.3%), with ultrasonography (USG) performed on 37 (24.6%) patients and magnetic resonance imaging on only one (0.6%). Retrograde urethrocystogram was performed when urethral injury was suspected (21 patients, 14%). In G1, all patients underwent USG to complement diagnosis. In G2, 12 patients underwent USG owing to a doubtful diagnosis. Mean follow-up was 34.6 months.


RESULTS
All patients in G1 were able to achieve erection after the initial traumatic event and immediate penile detumescence did not occur in any of the cases. Of the 125 patients evaluated in G2, 110 (92%) presented with disruption of the tunica albuginea and 15 (8%) showed injury of the dorsal vein of the penis. Urethral injury was found in 20 (16%) patients and was always associated with corpus cavernosum injury. Among 110 cases of PF, 95 (86.3%) presented with unilateral and 15 (13.7%) presented with bilateral lesions.


CONCLUSIONS
Patients with high suspicion of PF should be treated surgically. However, in cases of low suspicion of corpora cavernosum injury, based on clinical criteria and imaging methods, conservative treatment is a feasible and safe option.
Koifman
Leandro
L
Division of Urology, Souza, Aguiar Municipal Hospital, Rio de Janeiro, RJ, Brazil.
Barros
Rodrigo
R
Júnior
Ricardo A S
RA
Cavalcanti
André G
AG
Favorito
Luciano A
LA
D000293:Adolescent; D000328:Adult; D000368:Aged; D002944:Circumcision, Male; D003646:Debridement; D005500:Follow-Up Studies; D006406:Hematoma / Q000209:etiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010410:Penile Erection; D010413:Penis / Q000000981:diagnostic imaging / Q000293:injuries* / Q000473:pathology / Q000601:surgery; D011859:Radiography; D019651:Plastic Surgery Procedures; D020127:Recovery of Function; D012189:Retrospective Studies; D013536:Suture Techniques; D016896:Treatment Outcome; D014463:Ultrasonography; D014521:Urethra / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery; D014949:Wounds, Nonpenetrating / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery*; D055815:Young Adult