title: Long-term Treatment Outcomes Between Surgical Correction and Conservative Management for Penile Fracture: Retrospective Analysis.
abstract: OBJECTIVE
  Early surgical management is the standard of care for penile fracture. Conservative treatment is an option with recent reports revealing lower success rates. We reviewed the data and long-term outcomes of patients with penile injury submitted to surgical or conservative treatment.
  
  
  METHODS
  Between January 2004 and February 2012, 42 patients with penile blunt trauma on an erect penis were admitted to our center. We analyzed the following variables: age, etiology, symptoms and signs, diagnostic tests, treatment used, complications and erectile function during the follow-up. One patient was excluded due to missing information. Thirty-five patients underwent surgical repair and 6 patients were submitted to conservative management.
  
  
  RESULTS
  Mean follow-up was 19.2 months (range, 7 days to 72 months). The mean elapsed time from trauma to surgery was 21.3±12.5 hours. Trauma during sexual relationship was the main cause (80.9%) of penile fracture. Urethral injury was present in five patients submitted to surgery. Dorsal vein injury occurred in three patients with false penile fracture and concomitant spongious corpus lesion was present in three patients. During follow-up, 31 cases (88.6%) of the surgical group and four cases (66.7%) of the conservative group reported sufficient erections for intercourse, with no voiding dysfunction and no penile curvature. However, the remaining two patients (33.3%) from the conservative group developed erectile dysfunction and three patients (50%) developed penile deviation.
  
  
  CONCLUSIONS
  Surgical approach provides excellent functional outcomes and lower complications. Early surgical management of penile fracture provides superior results and conservative approach should be avoided.
authors.affiliation: Division of Urology, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil.
authors.forename: Kleiton Gabriel Ribeiro
authors.initials: KG
authors.lastname: Yamaçake
authors.forename: Alessandro
authors.initials: A
authors.lastname: Tavares
authors.forename: Guilherme Philomeno
authors.initials: GP
authors.lastname: Padovani
authors.forename: Giuliano Betoni
authors.initials: GB
authors.lastname: Guglielmetti
authors.forename: José
authors.initials: J
authors.lastname: Cury
authors.forename: Miguel
authors.initials: M
authors.lastname: Srougi
keywords: Penis; Surgery; Therapy; Wounds and injuries