Long-term Treatment Outcomes Between Surgical Correction and Conservative Management for Penile Fracture: Retrospective Analysis
Yamacake Kleiton Gabriel Ribeiro, Tavares Alessandro, Padovani Guilherme Philomeno, Guglielmetti Giuliano Betoni, Cury Jose, Srougi Miguel,
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( Yamacake Kleiton Gabriel Ribeiro )
Sao Paulo University Medical School Hospital das Clinicas Division of Urology
( Tavares Alessandro )
Sao Paulo University Medical School Hospital das Clinicas Division of Urology
( Padovani Guilherme Philomeno )
Sao Paulo University Medical School Hospital das Clinicas Division of Urology
( Guglielmetti Giuliano Betoni )
Sao Paulo University Medical School Hospital das Clinicas Division of Urology
( Cury Jose )
Sao Paulo University Medical School Hospital das Clinicas Division of Urology
( Srougi Miguel )
Sao Paulo University Medical School Hospital das Clinicas Division of Urology
KMID : 0358320130540070472
Abstract
Purpose: 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.
Materials and 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.
키워드
Penis;Surgery;Therapy;Wounds and injuries
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