Broken Penile Fracture is unique compared to other fractures in the body, as the penis doesn’t contain bones. During an erection, blood fills two cylindrical structures (corpora cavernosa) in the penis.

If the penis is bent suddenly or with force while it’s engorged, this can lead to the rupture of the tunica albuginea, the outer layer of these cylinders, causing a fracture.

Such an injury usually happens during sexual intercourse, for instance, if the penis accidentally hits the pelvis after slipping out of the vagina.

However, it can also occur through aggressive masturbation or the practice of taqaandan, which involves forcefully bending the tip of an erect penis to release an erection.

Broken Penile Fracture Symptoms

Broken Penile Fracture is a painful condition typically occurring in the lower two-thirds of the penis. Its symptoms include:

• Bleeding from the penis.
• The penis displaying dark-colored bruising.
• Difficulty in urinating.
• Hearing a cracking or popping sound at the time of injury.
• Sudden loss of erection.
• Pain ranging from minimal to severe.

Research indicates that if symptoms do not involve a popping sound or a rapid loss of erection, the injury might be different from a Broken Penile Fracture.

A common physical manifestation of a Broken Penile Fracture is the “eggplant deformity,” where the penis appears purple and swollen. Less common symptoms can include swelling in the scrotum and blood in the urine.

Conditions that may present similar symptoms to a Broken Penile Fracture are ruptured veins and arteries in the penis or a torn suspensory ligament.

To differentiate between these conditions, we, at Istanbul urology clinic, might ask for various imaging techniques and perform a physical examination.

Broken Penile Fracture Causes

The penis is less frequently injured compared to other body parts, but it can still sustain injuries from various causes:

1. Car Accidents: Impacts during vehicular accidents can result in penile injuries.
2. Machine Accidents: Injuries can occur from machinery, especially in industrial or construction settings.
3. Gunshot Wounds: Penile injuries can result from firearm-related incidents.
4. Burns: Thermal injuries can affect the penis.
5. Sexual Activity: The most common cause of penile injury is during sexual intercourse. An erect penis is less flexible and more prone to injury. For instance, if it slips out of the vagina during vigorous thrusting and strikes the partner’s body, it can bend sharply and potentially tear the tunica albuginea. This can cause a sharp pain and a “popping” sound, often followed by rapid loss of erection.
6. Sports: Various sports activities can lead to accidental injuries to the penis.

When the penis is not erect, it’s more flexible and less likely to be injured. The risk increases when it’s erect because the blood flow in the arteries makes it firm. 

A penile “fracture,” as termed by urologists, involves the tearing of the tunica albuginea, which is stretched tight during an erection.

Symptoms of a serious injury include persistent pain, hematoma (blood accumulation under the skin causing swelling and bruising), and blood at the tip of the penis or in urine, indicating possible damage to the urethra.

Additionally, using constricting devices like rubber tubes or rings around the base of the penis can cause injury.

If too tight or left on for too long, they can restrict blood flow and lead to severe damage. Inserting objects into the tip of the penis is also harmful and can damage the urethra and penis.

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Penile Fracture Risk Factors

Penile fractures can occur during any sexual position, but some behaviors heighten the risk. For heterosexual men, the woman-on-top position is particularly risky. 

In this position, if the penis is partially outside the vagina, the woman’s full weight might forcefully bend the erect penis. 

Additionally, excessive rocking forward or backward can bend the penis’s shaft. The rear-entry position is also known to be associated with penile injuries.

In some cultures, men engage in a practice known as taqaandan, or “penile cracking”. 

This involves bending the top of an erect penis by holding the shaft until a clicking sound is heard. Reasons for doing this include:

• Reducing an unwanted erection
• Trying to increase the size or straighten the penis
• As a habitual action, similar to knuckle cracking

When Should You Consult a Doctor?

It’s crucial for a man to get immediate medical care if he believes he has suffered a Broken Penile Fracture.

This condition is treated as an urgent medical issue by healthcare professionals, due to the serious risk it poses to a man’s long-term sexual and urinary health.

Typically, men will go to an emergency room for this issue. Prompt medical attention and treatment of the fracture significantly increases the chances of a complete recovery.

Penile Fracture Diagnosis

When diagnosing a penile injury, our urologist will take a comprehensive approach that includes some or all of the following:

1. Medical History: The urologist will first inquire about your medical history to understand any pre-existing conditions or factors that might contribute to or affect the injury.
2. Physical Examination: A thorough physical examination of the penis is conducted to assess the extent and nature of the injury.
3. Blood and Urine Tests: These tests are done to check for signs of internal damage, infection, or other related complications.
4. Urethral Examination with a Fiber Optic Camera: This procedure involves gently inserting a fiber optic camera into the urethra to directly visualize any internal damage.
5. Retrograde Urethrogram: In this diagnostic X-ray study, a special dye is injected through the urethra. X-rays are then taken to track the dye’s path. If the dye is seen leaking outside the urethra, it indicates a possible injury to this part of the urinary tract.
6. Imaging Techniques: Additional imaging methods like ultrasound, which uses sound waves, or MRI, which employs radio waves in a strong magnetic field, might be utilized.
   These techniques help in creating detailed images of the internal structures of the penis, aiding in a more accurate diagnosis.

Through these methods, the urologist aims to precisely determine the nature and severity of the penile injury to guide appropriate treatment.

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Penile Fracture Treatment in Turkey

The management of a Broken Penile Fracture involves both home care methods and, more critically, surgical intervention.

Home treatments include:

• Applying ice packs wrapped in cloth for 10-minute intervals to lessen swelling.
• Utilizing a Foley catheter for bladder emptying, minimizing further injury to the penis.
• Consuming anti-inflammatory medications like ibuprofen to alleviate pain and swelling.
• In some cases, doctors might advise wrapping the penis or using specialized “splints” to keep it positioned in a way that reduces strain.

However, relying solely on at-home treatments has been linked to a high incidence of complications post-penile fracture.

These complications can include pain during erections, significant curvature of the penis, and erectile dysfunction (inability to achieve an erection).

Consequently, many healthcare professionals advocate for surgical repair. Research indicates that surgical intervention tends to yield better outcomes for those with penile fractures.

The surgical approach depends on the severity of the injury. Surgical procedures following a Broken Penile Fracture may include:

• Removing a hematoma or accumulated blood caused by the fracture.
• Halting the bleeding from any injured blood vessels.
• Suturing any cuts or lacerations on the penis that might be bleeding.
• If the urethra is damaged, surgical repair may also be necessary.

To fix the fracture, a surgeon will make an incision in the penis’s skin to reach the torn areas and mend them with stitches.

Failure to seek appropriate treatment for a Broken Penile Trauma can lead to irreversible deformities of the penis.

Post-surgery, you will be required to stay in the hospital for about one or two days. The doctor will provide you with painkillers and antibiotics, which should be taken as instructed.

The healing process for the fracture post-surgery will take several weeks. During this period, you’ll need regular follow-ups which can be done online by contacting our medical adviser and the doctor’s team to monitor the healing progress, examine the penis’ veins and arteries, and evaluate blood circulation.

It is advised not to engage in sexual intercourse for at least one month following the surgery. Consult us to know more about ways to aid the recovery process.

Over 90 percent of surgeries are successful, as indicated by a reliable source. However, some men may face post-operative complications such as ED, penile curvature, and discomfort during erections, that’s why it’s important to have a full understanding of each case before going through any surgery.

Additionally, an untreated Broken Penile Trauma could result in difficulties maintaining an erection, commonly referred to as erectile dysfunction.

Advance cases Penile Trauma Treatment  

For patients experiencing complications from untreated Penile Fracture, such as erectile dysfunction, Istanbul Urology Clinic offers personalized treatment approaches. 

Depending on individual patient needs, our expert team may recommend one of the following advanced therapies:

Stem Cell Therapy for Penile Trauma Treatment:

Background:

Stem cell therapy represents a cutting-edge approach in medical treatments, leveraging the body’s natural healing mechanisms.

How it Works:

In the context of penile fracture, stem cells are harvested or in some kind of Stem cells, it can be premade and then injected into the penile tissue. These cells have the unique ability to transform into various types of cells, aiding in the repair and regeneration of damaged tissues.

Benefits:

This therapy can improve erectile function by enhancing blood flow and nerve regeneration in the penis. It’s a less invasive option compared to surgery and has been shown to have promising results in tissue restoration and function improvement.

Considerations:

The therapy’s effectiveness can vary based on the extent of injury and the patient’s overall health. It’s a relatively new approach, so long-term data on effectiveness and safety are still being gathered.

Penile Implant for Penile Trauma Treatment:

Background:

Penile implants are a well-established treatment for severe erectile dysfunction, often used when other treatments have failed.

How it Works:

The procedure involves surgically inserting a device into the penis. There are two main types of implants: inflatable and malleable (semi-rigid). Inflatable implants mimic a natural erection and are inflated via a pump placed in the scrotum. Malleable implants are always firm and can be bent into position when needed.

Benefits:

Penile implants have a high rate of patient satisfaction and are effective in restoring sexual function. They are a permanent solution and can be a good option for those who have not responded to other treatments.

Considerations:

As with any surgery, there are risks, such as infection. Recovery time varies, and patients typically need a few weeks to recover before they can resume sexual activity.

Both treatments are highly specialized and require a detailed consultation with a urologist.

The choice between stem cell therapy and a penile implant depends on various factors, including the patient’s medical history, the severity of the penile fracture, and personal preferences. 

The Istanbul Urology Clinic, with its team of experienced professionals, can provide comprehensive advice and support to patients making these decisions.

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Prevention

Prevention of penile injuries during sexual activity is largely achievable by ensuring that your partner is aware of the potential risks. Most Broken Penile Trauma typically occur when the female partner is on top. 

To prevent this, if your erect penis slips out of your partner’s vagina, it’s important to immediately cease any thrusting movements.

Additionally, other types of penile injuries can be prevented by exercising caution at work, particularly around machinery, practicing defensive driving, and adhering to gun safety protocols. Being mindful in these situations can significantly reduce the risk of injury.

Takeaway

In case of a suspected Broken Penile Trauma, it’s crucial to visit your local emergency services immediately. 

Treatment outcomes are significantly improved if the injury is addressed within the first 24 hours, as noted by a trustworthy source. 

Following surgical repair, most men regain their erectile function and report satisfaction with their sexual life.

To prevent injuries to the penis, ensure there is sufficient lubrication during sexual intercourse and exercise caution during intense or forceful penetration. 

Additionally, avoid forcefully placing an erect penis into tight clothing or rolling over onto an erection while in bed. Any abrupt or forceful impact on an erect penis can lead to either minor or major injuries.