The authors report a case of penile fracture associated with urethral injury, surgically repaired 72 hours after the initial trauma. The procedure involved penile degloving, hematoma evacuation, tunica albuginea repair, and primary urethroplasty over a catheter. A pharmacological rehabilitation protocol using phosphodiesterase type 5 inhibitors (PDE5i) was initiated postoperatively for three months. Despite the surgical delay, functional outcomes at 12 months were excellent, with an IIEF-5 score of 22/25, no evidence of fibrosis on color Doppler ultrasound, and preserved voiding function. This case highlights the efficacy of meticulous delayed surgery combined with early medical rehabilitation.
References
[1]
De Luca, F., Garaffa, G., Falcone, M., Raheem, A., Zacharakis, E., Shabbir, M., et al. (2017) Functional Outcomes Following Immediate Repair of Penile Fracture: A Tertiary Referral Centre Experience with 76 Consecutive Patients. Scandinavian Journal of Urology, 51, 170-175. https://doi.org/10.1080/21681805.2017.1280532
[2]
Yilmaz, H., Avci, I.E., Cinar, N.B., Akdas, E.M., Unal, M., Baynal, E.A., et al. (2023) Urethral Rupture Concomitant with Penile Fracture Does Not Adversely Affect Functional Outcomes. Urologia Journal, 90, 553-558. https://doi.org/10.1177/03915603221141171
[3]
Shebl, S.E. (2023) The Presentation and Outcomes of Penile Fracture with Associated Urethral Injury: A Systematic Literature Review. Archivio Italiano di Urologia e Andrologia, 95, Article No. 11082. https://doi.org/10.4081/aiua.2023.11082
[4]
Barros, R., Ribeiro, J.G.A., Silva, H.A.M.d., Sá, F.R.d., Fosse Júnior, A.M. and Favorito, L.A. (2020) Urethral Injury in Penile Fracture: A Narrative Review. International Brazilian Journal of Urology, 46, 152-157. https://doi.org/10.1590/s1677-5538.ibju.2020.99.02
[5]
Gentile, V., Modesti, A., LA Pera, G., Vasaturo, F., Modica, A., Prigiotti, G., et al. (1996) Ultrastructural and Immunohistochemlcal Characterization of the Tunica Albuginea in Peyronie’s Disease and Veno-Occlusive Dysfunction. Journal of Andrology, 17, 96-103. https://doi.org/10.1002/j.1939-4640.1996.tb01757.x
[6]
Girgin, R., ？eker, G., Turan, I., Kutu, F., Elma, Y. and Y？lmaz Can, E. (2024) The Effects of Topical Aloe Vera on an Experimentally Designed Penile Fracture Model in Rats. Turkish Journal of Trauma and Emergency Surgery, 30, 147-154. https://doi.org/10.14744/tjtes.2024.26425
[7]
Durrani, K., Corey, Z., Birk, A. and MacDonald, S.M. (2024) Atypical Presentation of a Penile Fracture with Unilateral Corpora Cavernosa and Urethral Injury. Cureus, 16, e67816. https://doi.org/10.7759/cureus.67816
[8]
Krishnani, H., Anjankar, A., Kakar, G., Sharma, S. and Kumar, A. (2022) Penile Fracture with Urethral Bleeding: A Urological Emergency. Cureus, 14, e31373. https://doi.org/10.7759/cureus.31373
[9]
Peng, J., Yuan, Y.M., Zhang, Z.C., Hong, Q., Cui, W.S., Gao, B., Song, W.D. and Xin, Z.C. (2013) Daily Low-Dose Tadalafil for Erectile Dysfunction Induced by Pelvic Fracture Urethral Disruption. National Journal of Andrology, 19, 443-445. (In Chinese)
[10]
Iblher, N., Fritsche, H.M., Katzenwadel, A., Penna, V., Eisenhardt, S.U., Stark, G.B., et al. (2012) Refinements in Reconstruction of Penile Skin Loss Using Intra-Operative Prostaglandin Injections, Postoperative Tadalafil Application and Negative Pressure Dressings. Journal of Plastic, Reconstructive & Aesthetic Surgery, 65, 1377-1383. https://doi.org/10.1016/j.bjps.2012.04.020
