The urethral injuries are repaired using simple interrupted sutures of 5-0 polyglactin placed under a Foley catheter. 2003 29:35-9.), is a circular sub-coronal incision and degloving of the penis, followed by debridement and synthesis of the injury, using simple interrupted sutures of 3-0 polyglactin. Penile fracture - experience in 56 cases. Koifman L, Cavalcanti AG, Manes CH, Filho DR, Favorito LA. The technique standardized in our institution, as previously described ( 6 6. Retrograde urethrography (RGU) was performed in selected cases when urethral injury was suspected.Īll patients underwent surgical treatment immediately after diagnosis. Complementary imaging methods such as USG and MRI of the penis were performed only in doubtful cases. Primary diagnosis assessment was performed through clinical history and physical examination. The medical records were systematically reviewed for epidemiological data, history and clinical presentation, etiology, and operative findings. Our institution is the biggest urologic emergency unit in Rio de Janeiro, a metropolitan area in Brazil with more than 6 million inhabitants. MATERIAL AND METHODSīetween January 1997 and January 2017, 285 patients with clinical diagnosis of PF were admitted to our facility and retrospectively assessed. The aim of this study is to report our experience over the past 20 years in the diagnosis and surgical treatment of PF along with the long-term outcomes. Penile fracture: long-term outcome of immediate surgical intervention. Ibrahiem el-HI, el-Tholoth HS, Mohsen T, Hekal IA, el-Assmy A. The treatment is usually surgical, where closure of the tunica albuginea is used to prevent sequelae such as erectile dysfunction (ED), curvature and painful erections ( 5 5. Penile fracture: diagnosis, treatment and outcomes of 150 patients. Koifman L, Barros R, Júnior RA, Cavalcanti AG, Favorito LA. However, in doubtful cases, additional examinations such as ultrasonography (USG) and magnetic resonance imaging (MRI) can be used for diagnostic confirmation ( 4 4. Penile fracture: surgical repair and late effects on erectile function. Ateyah A, Mostafa T, Nasser TA, Shaeer O, Hadi AA, Al-Gabbar MA. Generally, patients report hearing a cracking noise during sexual activity, followed by immediate pain and penile detumescence, in addition to the emergence of large edema and hematoma, leading to an ‘eggplant deformity’ ( 3 3. Sexual function and tunica albuginea wound healing following penile fracture: An 18-year follow-up study of 352 patients from Kermanshah, Iran. 2002 89:555-65.), but non-coital etiology (masturbation or penile manipulation) is also reported, especially in some Middle Eastern countries ( 2 2. Vaginal intercourse is the most common cause of PF ( 1 1. Penile fracture (PF) is a relatively uncommon form of urologic trauma. Surgical reconstruction produces satisfactory results, however, it can lead to complications, such as erectile dysfunction and penile curvature. Concomitant urethral injury should be considered in cases of highenergy trauma. The ‘doggy style’ and ‘man-on-top’ was the most common positions and generally associated with more severe lesions. Sexual activity was the most common cause. Hematoma and immediate penile detumescence are the most common clinical findings. PF has typical clinical presentation and no need for additional tests in most cases. Only two (3.7%) patients had complications after urethral reconstruction. Nine (14.7%) patients developed erectile dysfunction and eight (13.1%) had penile curvature. Urethral injuries were observed in 54 (18.7%) cases. Unilateral corpus cavernosum injuries were found in 199 (69%) patients and bilateral in 89 (31%) patients. The most common findings in the clinical presentation were hematoma, in all cases and detumescence in 238 (82.6%). Sexual trauma was the main etiological factor, responsible for 255 cases (88.5%): 110 (43.1%) occurred with the “doggy style” position, 103 (40.3%) with “man on top” position, 31 (12.1%) with the “woman on top” position and 11 (4.3%) in other sexual positions. Postoperative complications, sexual and urinary function were evaluated. Medical records were reviewed for clinical presentation, etiology and operative findings. Materials and methods:īetween January 1997 and January 2017, patients with clinical diagnosis of PF were admitted to our facility and retrospectively assessed. To report our experience over the past 20 years in the diagnosis and surgical treatment of penile fracture (PF).
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