The diagnosis and treatment of penile fracture: our 19-year experience

BACKGROUND
The aim of this study was to retrospectively evaluate our approach to the diagnosis and treatment of penile fracture.
METHODS
We retrospectively evaluated the results of 107 patients with penile fracture treated in our clinic between January 1990 and January 2009. Patient age, etiology of each fracture, history, physical examination results, radiologic findings, type of treatment, and postoperative complications were recorded. In 5 cases cavernosography was performed and in 8 cases retrograde urethrography.
RESULTS
The most common etiologies of penile fracture were coitus and manually bending the penis for detumescence. Diagnoses were made based on history and physical examination in 102 patients and cavernosography in 5 patients. In order to evaluate urethral injury in 8 cases, retrograde urethrography was performed. Rupture was repaired surgically in 101 patients, but 6 patients were treated conservatively. Among the 6 conservatively treated patients, 3 developed penile curvature 6 months post-treatment; no complications occurred in the surgically treated patients.
CONCLUSION
Cavernosography should be performed only when history and physical examination are insufficient for diagnosis, and retrograde urethrography should be performed when urethral injury is suspected. In order to prevent the development of penile curvature and to ensure rapid recovery, early surgical repair is advised.

Penis kýrýðýnýn taný ve tedavisi: 19 yýllýk deneyim

AMAÇ
Bu çalýþmada, penis kýrýklarýn taný ve tedavisine yaklaþýmlar retrospektif olarak deðerlendirildi.
GEREÇ VE YÖNTEM
Ocak 1990 ile Ocak 2009 tarihleri arasýnda kliniðimize penis kýrýðý nedeniyle baþvuran 107 hasta retrospektif olarak deðerlendirildi. Hastalarýn yaþý, kýrýðýn nedeni, kýrýðýn oluþ zamaný, fiziksel inceleme bulgularý, radyolojik bulgular, uygulanan tedavi þekli ve ameliyat sonrasý komplikasyonlar kaydedildi. Beþ hastaya kavernozografi ve 8 hastaya retrograd üretrografi yapýldý.
BULGULAR
Cinsel iliþki ve uygunsuz ortamda erekte peniste detümesansý saðlamak için elle bükme penis kýrýðýnýn en sýk nedenleri olarak bulundu. Taný 102 hastada anamnez ve fiziksel incelemeyle kondu. Kavernozografi 5 hastada yapýldý. Üretral yaralanma düþünülen 8 hastaya retrograd üretrografi yapýldý. Yýrtýklar 101 hastada cerrahi olarak onarýldý, 6 hastaya ise konservatif tedavi yapýldý. Ameliyattan sonraki 6. ayda yapýlan kontrollerde konservatif tedavi yapýlan 6 hastanýn 3’ünde penil kurvatur geliþirken cerrahi yapýlan hastalarda hiçbir komplikasyon geliþmedi.
SONUÇ
Anamnez ve fiziksel inceleme ile kesin taný konulamayan hastalarda kavernozografi, üretra yaralanmasý þüphesi olanlara ise üretrografi yapýlmalýdýr. Penis kýrýðýnýn erken cerrahi onarýmý penis kurvatur geliþimini önlemek ve hýzlý iyileþmeyi saðlamak için önerilmektedir.