PENILE FRACTURE (FRACTURE OF THE PENIS): STRUCTURE AND MECHANISM OF AN ERECT PENIS, CAUSES, SIGNS AND SYMPTOMS, TREATMENT AND COMPLICATIONS

OVERVIEW

Penile fracture is an emergency condition caused when the erect penis is forcefully and rapidly bent so much that the internal tubes (corpus spongium and corpus cavernosum) pushes into each other and even ruptures the fibrous envelope (tunica albuginea) of the penis. It most commonly happens during aggressive sexual intercourse or masturbation. Its signs and symptoms are immediate and include: an audible popping or cracking sound, acute pain, immediate flaccidity (i.e. the penis falls), darkening and swelling of the skin around the penis. Treatment is only by surgery which must be done immediately and adequately to avoid complications

Penile Fracture

CAUSE/STRUCTURE AND MECHANISM OF AN ERECT PENIS

Before we talk about penile fracture, let us give a simple explanation behind the mechanism of an erect penis.

The thickness of the penis is made up of two main cylindrical-like tubes:

• An inner tube, called the corpus spongium, which also houses the urethra (the tube from where we urinate) and culminates into the glans penis (the tip of the penis)

• A larger tube, called the corpus cavernosum , which surrounds the corpus spongium. This tube is further surrounded by a fibrous envelope known as tunica albuginea

These tubes lie along the entire length of the penis (right from the pubic bones to the tip penis) and are internally made up of sponge-like tissues. During an erection, these sponge-like tissues become filled with blood, making the penis to be erect.

Penile fracture occurs when, as the penis is erect, a rapid external force is exerted to it causing it to bend in such a way that the corpus spongium pushes deep into the corpus cavernosum and even ruptures the tunica albuginea. It is caused by aggressive sexual intercourse or masturbation and could cause a partial or complete rupture of the urethra and injury to nerves, veins and arteries

Structure of the penis: The penis is made up of an inner tube called the Corpus spongium, outer tubes called the Corpus cavernosum, and an outermost fibrous envelope called the Tunica albuginea

SIGNS AND SYMPTOMS

Signs and syptoms of a penile fracture happens immediately. They include:

• Audible popping or cracking sound

• Acute pain 

• Immediate flaccidity (i.e. the penis falls) 

• Darkening and swelling of the skin around the penis due to blood escaping the cylinders and pouring into the surrounding skin. 

• Blood may even be visible at the urinary opening.

The skin around the penis immediate darkens and swells up due to blood escaping from the tubes into it

TREATMENT/COMPLICATIONS

Penile fracture is a medical emergency and should be attended to urgently. Its treatment is by surgical repair of the affected regions. If there is delay of treatment or inadequate surgical repair, complications could occur such as 

• Erectile dysfunction

• Permanent bending of the penis

• Damage to the urethra

• Pain during sex.

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