Management of penile fracture: Can it wait?
Objectives: To assess the effect of timing of presentation of cases with penile fracture on the long-term outcome of surgical intervention.
Patients and methods: Between 2000 and 2015, 42 patients with penile fracture were operated in our centre, immediately after admission. To assess the effect of timing of presentation, patients were classified into 2 groups: group 1 with early presentation (≤24 h) and group 2 with delayed presentation (>24 h). All patients had a routine follow-up visit at 6 months after surgery; during this visit, long-term complications were assessed.
Results: Group 1 included 26 patients (62%) and group 2 included 16 (38%). In group 1, patients presented to the emergency department from within 24 h (mean: 3.96 ± 2.47 h) after occurrence of the penile trauma. Patients in group 2 presented from 24 h to 4 days (mean: 79.50 ± 37.62 h). The incidence rate of long-term complications was 7.6% and 68.7% in group 1 and group 2, respectively (OR 26.4, 95% CI 4.41–157.86, p = 0.0001). Concerning erectile dysfunction and penile nodules, there was no significant difference between the two groups (p = 0.67 and 0.06, respectively). However, painful penetration was significantly higher in group 2 (50% vs 3.8% in group 2 and 1, respectively, OR 25, 95% CI 2.69–231.59, p = 0.001). Penile curvature was seen only in the second group (43.8%).
Conclusion: Immediate surgical repair has the best prognosis and should remain the recommended treatmentmodality of penile fracture.