EXPERIENCE WITH THE SURGICAL MANAGEMENT OF FRACTURE PENIS

Objective: To know the etiology, complications and outcome of surgical management of fracture penis. Material and Methods: This descriptive study carried out in the surgical departments of Lady Reading Hospital Peshawar from April 2000 to March 2005. Patients with the clinical diagnosis of fracture penis were admitted and operated. All patients except those with haematuria were catheterized. Most of these patients were explored via a circumcoronal incision and the defect in the tunica of corpus cavernosum repaired with 3/0-vicryl suture. No drain was used and a light compression dressing was done in all patients. Catheter was removed on the second postoperative day. Follow up was arranged at 6 and 24 months of operation. Results: During the study period 51 patients were operated for fracture penis. Mean age at presentation was 32 years. he commonest cause of fracture penis was manual fiddling with the organ to overcome an erection (39.2%). The incidence of associated urethral injury was 1.96% (n=1/51). The commonest mode of presentation was with a cracking sound, local pain and immediate detumescence (90%, 98% & 94% respectively). Average hospital stay was 3.4 days. Immediate postoperative complication was urinary retention in 2 patients (3.92%). Long-term complications were negligible. There was only one readmission at 6 months for urethral stricture that responded well to optical urethrotomy. Conclusion: The commonest cause of fracture penis is manual manipulation to overcome an erection. The best treatment option is immediate surgical repair.