Penile Fracture in Southern Nigeria: A 10‑Year Review in Two Tertiary Referral Centers

Abstract

Background: Penile fracture is an uncommon genitourinary emergency due to an abrupt trauma to an erect penis. Urgent exploration and repair of tunica albuginea tear is advocated. This study aimed to assess the etiology, presentation, location of the tear, and management outcome of penile fracture in two tertiary hospitals in southern Nigeria.

Patients and Methods: Data were obtained retrospectively from the patients’ health records in the two tertiary hospitals from April 2009 to March 2019. Their biodata, mechanism of injury, injury-to-presentation time, clinical features, location of the injury, the treatment offered, duration of hospital admission, and follow‑up were studied.

Results: Thirteen patients aged 22–54 years (mean 34.0 years) were treated within the 10-year study period. Ten (76.9%) had tertiary education, while 7 (53.8%) were married. Heterosexual intercourse accounted for penile fracture in 12 (92.3%) patients while rolling over an erect penis in bed in 1 (7.7%) case. Male‑dominant sex position (n = 9; 69.2%) was the most predominant. In 8 (61.5%) patients, girlfriends/mistresses were involved. Most patients (n = 9; 69.2%) presented within 24 h, while one came after 7 days. All patients presented with penile pain, crackling sound, sudden detumescence, swelling, and penile deformity. The left corpus cavernosum was affected in 9 (69.2%) patients. Three patients (23.1%) had associated urethral injuries. All patients had surgical exploration and repair with minimal complications. Average hospital admission and follow-up duration were 6.7 days and 9.3 months, respectively. Conclusion: Heterosexual intercourse was the predominant cause of penile fracture in our study. Surgical management gave excellent outcomes even in delayed presentation.

Keywords: Erect penis, penile fracture, Southern Nigeria, surgical repair, urethral injury