Sexual Function Outcomes After Surgical Treatment of Penile Fracture

ABSTRACT: Introduction: Penile fracture is a urologic emergency and is defined as the rupture of the tunica albuginea of the cavernous body in erection. Aim: Our study aims to evaluate patients with penile fracture and to identify the factors that may influence the sexual function after surgical re...

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Main Authors: Yassine Ouanes, MD, Mohamed Hafedh Saadi, MD, Houssem Haj Alouene, MD, Mokhtar Bibi, MD, Ahmed Sellami, PhD, Sami Ben Rhouma, PhD, Yassine Nouira, PhD
Format: Article
Language:English
Published: Oxford University Press 2021-06-01
Series:Sexual Medicine
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2050116121000337
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author Yassine Ouanes, MD
Mohamed Hafedh Saadi, MD
Houssem Haj Alouene, MD
Mokhtar Bibi, MD
Ahmed Sellami, PhD
Sami Ben Rhouma, PhD
Yassine Nouira, PhD
author_facet Yassine Ouanes, MD
Mohamed Hafedh Saadi, MD
Houssem Haj Alouene, MD
Mokhtar Bibi, MD
Ahmed Sellami, PhD
Sami Ben Rhouma, PhD
Yassine Nouira, PhD
author_sort Yassine Ouanes, MD
collection DOAJ
description ABSTRACT: Introduction: Penile fracture is a urologic emergency and is defined as the rupture of the tunica albuginea of the cavernous body in erection. Aim: Our study aims to evaluate patients with penile fracture and to identify the factors that may influence the sexual function after surgical repair. Methods: A total of 138 patients who were diagnosed with penile fracture between January, 1999 and December, 2018 were reviewed. Clinical features, perioperative assessment, time from injury to surgery, tunica defect properties, and presence of urethral injury were assessed. Main Outcome Measures: Sexual function was evaluated by three parameters six months after surgical repair: International Index of Erectile Function-5 (IIEF-5) questionnaire, penile curvature and the presence of a painful intercourse. All factors that could potentially influence these parameters were analyzed. Results: The mean age was 31.2 years (19-55). Presentation delay ranged from 1 to 5 days (mean = 16.8 hours) while surgery delay was 14.3 hours ().The most common cause of penile fracture in our patients was forcefully bending of the erect penis to achieve detumescence in 62 cases (44.9%). On multivariate analysis, we found that the presentation delay and the fracture site located in the proximal shaft of the penis showed significant difference in the occurrence of postoperative ED (P = 0.03 and P = 0.015 respectively). Presentation delay, elective incision and tuncial leak located in the proximal shaft (P = 0.045; P = 0.018 and P = 0.022 respectively) were associated with higher penis curvature. Conclusion: Immediate surgical repair and circumferential degloving incision for tunical leaks located in the proximal shaft of the penis are recommended in order to decrease the incidence of ED after surgical repair of penile fractures. Ouanes Y, Saadi MH, Alouene HH, et al. Sexual Function Outcomes After Surgical Treatment of Penile Fracture. Sex Med 2021;9:100353.
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spelling doaj.art-cf39c04e49104abbbfbeb4e15182aa1b2023-08-02T00:31:20ZengOxford University PressSexual Medicine2050-11612021-06-0193100353Sexual Function Outcomes After Surgical Treatment of Penile FractureYassine Ouanes, MD0Mohamed Hafedh Saadi, MD1Houssem Haj Alouene, MD2Mokhtar Bibi, MD3Ahmed Sellami, PhD4Sami Ben Rhouma, PhD5Yassine Nouira, PhD6Urology Department, Hopital La Rabta, Tunis, TunisiaCorresponding Author: Mohamed Hafedh Saadi, MD, Resident in Urology, Urology Department, Hopital La Rabta, La Rabta Jebbari, 1007, Tunis, Tunisia. Tel: 2165 473 9124; Fax: 0021671407103; Urology Department, Hopital La Rabta, Tunis, TunisiaUrology Department, Hopital La Rabta, Tunis, TunisiaUrology Department, Hopital La Rabta, Tunis, TunisiaUrology Department, Hopital La Rabta, Tunis, TunisiaUrology Department, Hopital La Rabta, Tunis, TunisiaUrology Department, Hopital La Rabta, Tunis, TunisiaABSTRACT: Introduction: Penile fracture is a urologic emergency and is defined as the rupture of the tunica albuginea of the cavernous body in erection. Aim: Our study aims to evaluate patients with penile fracture and to identify the factors that may influence the sexual function after surgical repair. Methods: A total of 138 patients who were diagnosed with penile fracture between January, 1999 and December, 2018 were reviewed. Clinical features, perioperative assessment, time from injury to surgery, tunica defect properties, and presence of urethral injury were assessed. Main Outcome Measures: Sexual function was evaluated by three parameters six months after surgical repair: International Index of Erectile Function-5 (IIEF-5) questionnaire, penile curvature and the presence of a painful intercourse. All factors that could potentially influence these parameters were analyzed. Results: The mean age was 31.2 years (19-55). Presentation delay ranged from 1 to 5 days (mean = 16.8 hours) while surgery delay was 14.3 hours ().The most common cause of penile fracture in our patients was forcefully bending of the erect penis to achieve detumescence in 62 cases (44.9%). On multivariate analysis, we found that the presentation delay and the fracture site located in the proximal shaft of the penis showed significant difference in the occurrence of postoperative ED (P = 0.03 and P = 0.015 respectively). Presentation delay, elective incision and tuncial leak located in the proximal shaft (P = 0.045; P = 0.018 and P = 0.022 respectively) were associated with higher penis curvature. Conclusion: Immediate surgical repair and circumferential degloving incision for tunical leaks located in the proximal shaft of the penis are recommended in order to decrease the incidence of ED after surgical repair of penile fractures. Ouanes Y, Saadi MH, Alouene HH, et al. Sexual Function Outcomes After Surgical Treatment of Penile Fracture. Sex Med 2021;9:100353.http://www.sciencedirect.com/science/article/pii/S2050116121000337Penile FractureSexualityErectile DysfunctionTraumatology
spellingShingle Yassine Ouanes, MD
Mohamed Hafedh Saadi, MD
Houssem Haj Alouene, MD
Mokhtar Bibi, MD
Ahmed Sellami, PhD
Sami Ben Rhouma, PhD
Yassine Nouira, PhD
Sexual Function Outcomes After Surgical Treatment of Penile Fracture
Sexual Medicine
Penile Fracture
Sexuality
Erectile Dysfunction
Traumatology
title Sexual Function Outcomes After Surgical Treatment of Penile Fracture
title_full Sexual Function Outcomes After Surgical Treatment of Penile Fracture
title_fullStr Sexual Function Outcomes After Surgical Treatment of Penile Fracture
title_full_unstemmed Sexual Function Outcomes After Surgical Treatment of Penile Fracture
title_short Sexual Function Outcomes After Surgical Treatment of Penile Fracture
title_sort sexual function outcomes after surgical treatment of penile fracture
topic Penile Fracture
Sexuality
Erectile Dysfunction
Traumatology
url http://www.sciencedirect.com/science/article/pii/S2050116121000337
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