What is it about?

To investigate the impact of immediate surgical repair and conservative treatment of penile fracture (PF) on penile vascular indices.

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Why is it important?

Rupture of the corpus cavernosum by blunt trauma to an erect penis is defined as ‘‘penile fracture.’’ Often, only 1 corpus cavernosum is involved, but both corpora may be injured. In 20–30 % of the cases, the tear may extend into the corpus spongiosum, and as a result partial or complete urethral rupture will develop. Sexual intercourse and masturbation are the most common causative events . Female on top position increases the risk of PF. To our experience, compared to healthy normal population, significant number of affected individuals (either surgically treated or conservatively treated) will develop devastating physical and functional problems. Intact tunica albuginea has outmost importance in normal penile tumescence and rigidity. A pressure in excess of 1500 mm Hg is required to rupture tunica. Most studies recommend early surgical repair to restore the tunica albuginea integrity and to reduce the late complications of penile curvature, such as fibrosis formation and erectile dysfunction (ED) . However, immediate or early surgical repair does not guarantee future normal erectile function (EF).

Perspectives

In this study, we compared penile vascular status in surgically treated patients and in men who have been treated conservatively. Our results show that venoocclusive disease is non-significantly more common in conservatively treated patients than in surgically treated patients. Additionally, the prevalence of pure arterial insufficiency was non-significantly greater in patients who had been treated surgically than in conservatively treated men. In addition, the comparison between two groups showed that there was no statistical difference for non-vascular prevalence. Furthermore, surgically treated patients had nonsignificantly higher mixed vascular disease prevalence than conservatively treated patients.

Dr Mohammad Reza Safarinejad
University of Medical Sceices

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This page is a summary of: Penile vascular indices in surgically treated and conservatively treated penile fracture: does conventional immediate repair matter?, International Urology and Nephrology, September 2012, Springer Science + Business Media, DOI: 10.1007/s11255-012-0284-z.
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