Surgical reconstruction for penile fracture: a systematic review

Penile fracture is a rare condition that describes the rupture of the corpus cavernosum following direct, high-pressure trauma to the erect penis. There is no standardized management algorithm for these patients. We performed a systematic review of the past 10 years regarding management of penile fractures.

A complete PRISMA-P 2015 checklist was performed where we reviewed English articles published over the past 10 years to identify 105 articles, where 63 articles were of relevance and subsequently narrowed to a total of 28 articles into the final review for this study. We determined that immediate penile exploration and tunica repair is considered the most common and current management of penile fractures with experts demonstrating that it leads to the fastest in recovery in erectile function and positive cosmetic outcomes. However, we also determined that the specific algorithm can be variable—down to the suture material, use of catheterization, urethroplasty when involved, and length of recovery/follow-up. In the last several decades, men with penile fracture have been treated, in most cases, with immediate surgical intervention.

This review highlights the varying practices regarding surgical exploration, injury repair, and postoperative management in men with a penile fracture. Immediate penile exploration and tunica repair have been the mainstay approach of management.

Authors: Hal Kominsky, Sarah Beebe, Nayan Shah & Lawrence C. Jenkins, Department of Urology, The Ohio State University Wexner Medical Center, Columbus, OH, USA.

Source: Kominsky, H., Beebe, S., Shah, N. et al. Surgical reconstruction for penile fracture: a systematic review. Int J Impot Res (2019) doi:10.1038/s41443-019-0212-1.