Fracture of the penis in Jos, Nigeria: review of cases in 2020

Authors

  • Chimaobi G. Ofoha Department of Surgery, Jos University Teaching Hospital, Jos, Nigeria Department of Surgery, College of Health Sciences, University of Jos, Nigeria
  • Ifiok P. Umana Department of Surgery, Jos University Teaching Hospital, Jos, Nigeria
  • Adedeji G. Adewale Department of Surgery, Jos University Teaching Hospital, Jos, Nigeria

DOI:

https://doi.org/10.18203/2349-3933.ijam20212103

Keywords:

Fracture, Penis, Sexual intercourse, Penile fracture, Jos

Abstract

Background: Penile fracture is a urological emergency and requires urgent medical attention. There was a relative upsurge in 2020. Diagnosis is usually based on typical history and examination findings suggestive of penile fracture. The objective of this study was to determine the demographics, clinical presentation and management of fracture of the penis.

Methods: All patients who presented at the accident and emergency in 2020 with penile fracture were studied. The patients age, time to presentation, mechanism of injury, clinical features (cracking sound, pain, immediate detumescence, penile swelling, urethral bleeding and acute urinary retention) were recorded. Intraoperative findings (location of corpora rupture, length of tear and urethral rupture) were recorded and analysed.

Results: Twelve patients were studied. The mean age was 34.8 years, range (20 years to 56 years). 58.3% presented within 24 hours of trauma. The commonest mechanism of penile fracture was sexual intercourse with the woman on top position (58%). 75% of the patients heard a popping sound. All patients had pain, detumescence and penile swelling (N=12) 100%. Two patients had urethral bleeding (N=2) 16.7%, with one having associated urethral rupture (N=1) 8.3%. Two patients had acute urinary retention (16.7%). Rupture of the right corpora occurred in 50%, 8.3% had bilateral rupture of the corpora. All the patients had repair of the corporal rupture. Urethral injury was repaired primarily. Erection and voiding post-repair were satisfactory.

Conclusions: Fracture of the penis is a urological emergency. Diagnosis can be made based on typical history and examination findings. Prompt surgical intervention is advised to avoid complications and erectile dysfunction.

Author Biography

Chimaobi G. Ofoha, Department of Surgery, Jos University Teaching Hospital, Jos, Nigeria Department of Surgery, College of Health Sciences, University of Jos, Nigeria

Consultant

References

Gulmi FA. Penile Fracture. Rev Urol. 2018;20(1):41-2

El-Taher AM, Aboul-Ella HA, Sayed MA, Gaafar AA. Management of penile fracture. J Trauma. 2004;56(5):1138-40.

Lee SH, Bak CW, Choi MH, Lee HS, Lee MS, Yoon SJ . Trauma to male genital organs: a 10-year review of 156 patients, including 118 treated by surgery. BJU Int. 2008;101(2):211-5.

Shariat M, Sufian M. Role of ultrasound in diagnostic aid of a case of penile fracture. Shiraz E Med J. 2008;9(3):158-62.

Rodriguez D, Li K, Apoj M, Munarriz R. Epidemiology of penile fractures in United States emergency departments: Access to care disparities may lead to suboptimal outcomes. J Sex Med. 2019;16(2):248-56.

Omisanjo OA, Bioku MJ, Ikuerowo SO, Sule GA, Esho JO. A prospective analysis of the presentation and management of penile fracture at the Lagos State university teaching hospital (LASUTH), Ikeja, Lagos, Nigeria. Afr J Urol. 2015;21(1):52-6.

McDougal WS, Wein AJ, Kavoussi LR, Partin AW, Peters CA. Campbell-Walsh Urology. 10th ed. New York: Elsevier Health Sciences; 2016.

Mirzazadeh M, Fallahkarkan M, Hosseini J. Penile fracture epidemiology, diagnosis and management in Iran: a narrative review. Transl Androl Urol. 2017;6(2):158-66.

Nawaz H, Khan M, Tareen FM, Khan S. Penile fracture: presentation and management. J Coll Physicians Surg Pak. 2010;20(5):331-4.

Koifman L, Cavalcanti AG, Manes CH, Filho DR, Favorito LA. Penile fracture: experience in 56 cases. International Braz J Urol. 2003;29(1):35-9.

Ugwu BT, Yiltok SJ, Uba AF, Abdulamajid UF. Fracture of the penis-a rare injury on the Jos Plateau, Nigeria. Central Afr J Med. 1998;44(4):107-8.

El-Taher AM, Aboul-Ella HA, Sayed MA, Gaafar AA. Management of penile fracture. J Trauma Acute Care Surg. 2004;56(5):1138-40.

Ekeke ON, Eke N. Fracture of the penis in the Niger Delta region of Nigeria. J West Afr Coll Surg. 2014;4(3):1-19.

Ofoha CG, Magnus FE. Presentation, characteristics and co-morbidities of men with prostate cancer in Nigeria. J Adv Medicine Med Res. 2019;31(5):1-7.

Eke N. Fracture of the penis. Br J Surg. 2002;89(5):555-65.

Zargooshi J. Sexual function and tunica albuginea wound healing following penile fracture: an 18‐year follow‐up study of 352 patients from Kermanshah, Iran J Sex Med. 2009;6(4):1141-50.

Anselm O, Okechuhwu O. Penile fracture from entrapment of an erect penis in the African Bamboo bed: a case report. African J Urol. 2010;16(1):24-6.

Kamdar C, Mooppan UM, Kim H, Gulmi FA. Penile fracture: preoperative evaluation and surgical technique for optimal patient outcome. BJU Int. 2008;102(11):1640-4.

Mbonu OO, Aghaji AE. Fracture of the penis in Enugu, Nigeria. J R Coll Surg Edinb. 1992;37:309-10.

Al‐Shaiji TF, Amann J, Brock GB. Fractured penis: diagnosis and management (CME). J Sex Med. 2009;6(12):3231-40.

Nicolaisen GS, Melamud A, Williams RD, McAninch JW. Rupture of the corpus cavernosum: surgical management. J Urol. 1983;130(5):917-9.

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Published

2021-05-26

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Original Research Articles