A penile fracture, i.e. a rupture of the cavernous body or the surrounding tissue layer, is a rare but serious injury to the male genital organ. A penile rupture always requires medical attention, in most cases surgery is unavoidable to prevent possible long-term consequences such as erectile dysfunction.
What is a penis fracture?
The term penile fracture is misleading, since the so-called penile rupture is not a bone fracture. The penis contains no bone. See foodanddrinkjournal for Persistent Hyperplastic Primary Vitreus (abbreviated as PHPV) Dictionary Definitions.
A penile rupture tears the tunica albuginea, the layer of tissue that surrounds the erectile tissue of the penis and helps maintain an erection. The erectile tissue of the penis itself can also be overstretched or even tear.
A penile rupture can only occur when the penis is erect, namely when the erect member is bent too much. A penile rupture is relatively rare, but almost always requires medical attention.
Causes
The most common causes of penile rupture are related to vaginal intercourse or masturbation. This can cause the penis to snap when it hits the woman’s pelvic bone or perineum.
This most commonly occurs when the woman sits on top of the man (“rides”) during intercourse and loses the penis, causing her weight to snap the penis. Penile ruptures can also occur when attempting to erect the penis hide and it is pushed down too hard.
Rarely can a man rupture a penis while sleeping. This can happen if he lies with his entire weight on the erect limb and this is severely bent as a result. If the penis is injured while it is flaccid, for example by being kicked or punched, this does not result in a penile rupture. This injury can only occur during an erection.
Symptoms, Ailments & Signs
In most cases, a penis fracture is immediately apparent as a cracking noise in the erect penis. There is a sudden loss of erection (which is a prerequisite for the rupture of the erectile tissue) and thus a brief relaxation of the penis. There is immediate severe pain in the torn area of the erectile tissue, which can radiate. The pain can involve the lower abdomen, testicles, and back.
One or more swellings occur. Blue and red hematomas occur very quickly and sometimes lead to discoloration of the entire limb. The swelling may also involve the pubic bone and testicles, depending on the location of the rupture. The swelling can cause the penis to curve unnaturally around the intact erectile tissue. Accordingly, the bend usually occurs to the top right or top left.
In some cases, the rupture is palpable and allows the limb to be crushed at the site of the greatest swelling. In rare cases, there is also a rupture of the erectile tissue, which allows blood to leak out of the urethra. However, this is a rare symptom of penile fracture.
Diagnosis & History
The diagnosis is made by visual and tactile findings by the attending physician. The presumptive diagnosis often results from the anamnesis. Those affected typically describe a loud cracking noise.
The penis immediately relaxes and the man feels a sharp pain in the genital area. In addition, a large, dark hematoma can be seen on the swollen penis. This bruise alone usually allows a simple visual diagnosis. If the urethra has been injured, blood may be found in the urine. In order to diagnose an injury to the urethra, a urethography is created, i.e. an X-ray of the urethra in which a contrast medium is injected.
The further course of this injury depends on the treatment. Basically, the prognosis is good. If there is no treatment, this can lead to a curvature of the penis or problems with an erection.
Complications
A penile rupture entails a number of complications, which occur more frequently the longer the operation on the affected erectile tissue is delayed. It is true that quick action and medical care of the limb and the urethra can prevent complications.
For example, a penile fracture can lead to penile curvature (acquired penile curvature) because the tissue may scar or heal in a compressed shape. Such curvature is primarily an aesthetic problem but, depending on its severity, can also cause significant difficulties during sexual intercourse.
Urethral narrowing can also occur. It can be caused by a narrowing of the defective tissue that grows together or can also be caused by an injury to the urethra as part of medical care. This can scar them. This leads to problems with urination, an increased susceptibility to infections and can lead to pain. A urethral stricture is treatable.
If the cavernous bodies are irreparably damaged, or if there is nerve damage, erectile dysfunction can occur. The partial or complete loss of erectile function often means severe psychological stress for those affected. It can also cause pain when erections occur after surgery. It is possible that these will persist for a long time.
When should you go to the doctor?
If a noise similar to that of a cracking sound can be heard in the man’s intimate area during the sexual act, the penis is often fractured. A doctor’s visit should be made immediately, since severe pain in the limb begins immediately at the same moment. If the penis begins to swell and the erection returns immediately, it is advisable to consult a doctor. Discolouration, bruising and the spread of pain should be presented to a doctor as soon as possible.
Due to the numerous risks, side effects and complications, taking painkillers on your own responsibility should be avoided. The medicines should only be taken after consultation with a doctor in order to achieve the best possible treatment result. If the fracture point on the male penis can be palpated, there is a need for action. In the case of bleeding from the penis, sequelae have developed as a result of the fracture of the penis. A doctor’s visit is necessary so that there is no increase in further symptoms.
Behavioral problems, aggressive tendencies or tearfulness are additional signs of a health irregularity. If there is a racing heart, cardiac arrhythmia and clouding of consciousness, the person concerned needs help. In the event of a loss of consciousness, the emergency doctor must be alerted. In these cases, those present are obliged to initiate first aid measures so that there are no further impairments or life-threatening conditions.
Treatment & Therapy
To prevent any complications, it is advisable to see a doctor immediately if there is a suspicion of a penile injury. In many cases, an operation is unavoidable. This is all the more promising the faster it can be carried out.
An operation is intended to prevent functional disorders from occurring as a result of the penile rupture. The first step after a penile rupture is to cool the affected area with ice, as this will reduce the extent of the swelling. If the rupture is not severe, it can be treated conservatively. A pressure bandage is placed and the penis is cooled.
Since a penile rupture is very painful, painkillers are also given. There is also treatment with medication to reduce painful erections. After an operation on the penis, it is necessary not to have sexual intercourse for at least four weeks so that the suture can heal well and is not exposed to heavy loads.
Outlook & Forecast
An untreated or only conservatively treated penile fracture can have serious consequences depending on its severity. In the area of the rupture, there is initially a risk of bacterial infection. This can be minimized by administering antibiotics. In addition to persistent pain and swelling, expanding bruises can develop in individual cases. The urethra can also be affected and narrow. Blood in the urine is an indicator of this. If such a narrowing of the urethra develops, bladder and kidney problems can occur as a result.
As a long-term consequence of the erectile tissue rupture, a penile curvature (“penile deviation”) is possible. This develops when the tissue heals from being compressed or scars. Some men experience erectile dysfunction through to impotence in connection with acquired penile curvature. A penis deviation can also lead to pain during later sexual intercourse.
If the fracture is operated on promptly, the chances of healing without complications are statistically very good. Subsequent operations, especially after bridging conservative treatment, regularly lead to good results.
Some men report sexual dysfunction despite successful surgery. These can be a temporary psychological consequence of the fact that the fracture of the penis was experienced as traumatic. Psychotherapeutic treatment can support the path to holistic recovery.
Prevention
Basically, penile ruptures are rare injuries, which are mainly caused by very violent sexual activity. Awareness that such a thing as a penile rupture exists and how it can occur is an important step in preventing injury. In addition, care should be taken when handling the penis during sexual intercourse and masturbation.
Aftercare
As a rule, no medical follow-up care is necessary after a penis fracture. The disease heals well with appropriate protection. Complications and consequences are the exception. A penile fracture can occur again at any time. The male member is always in the excited state. Patients should therefore refrain from excessive movements during comedy as part of the aftercare. This will prevent it from breaking again.
The treating physician informs about an inappropriate use. The person concerned is responsible for implementing the recommendations themselves. Despite the scientific possibilities, consequences of a penile fracture sometimes remain. These consist of a narrowing of the urethra or impotence.
These diseases bring with them the need for further therapies. Organic malfunctions are best treated surgically. Imaging procedures such as an MRI or CT provide conclusions about the extent of the disease. Erectile dysfunction, on the other hand, is usually associated with psychological causes. A doctor may prescribe talk therapy or drugs to increase desire, if necessary.
Unlike cancer, a penile fracture does not entail close follow-up examinations. Consequences are rarely to be expected after complete healing. If they do occur, the diseases must be remedied as part of further treatment.
You can do that yourself
In the event of a penile fracture, an ambulance must be called or expedited transport to the emergency room. Self-treatment or attempts at self-therapy are not recommended. Wearing loose clothing helps to support medical care. Tight-fitting underpants or trousers intensify existing pain and should therefore not be worn. The buttocks area should be protected from the external impact of objects. Therefore, the pockets of the clothing must be emptied so that neither keys nor a mobile phone can come into contact with the intimate area through movements.
Sexual activity of any kind should be avoided during the healing process. This also includes cognitive processes and sexual fantasies. The erectile tissue must be relieved and would immediately hurt if sexually stimulated. Mental stress must be reduced to avoid later erectile dysfunction. An inner serenity in dealing with what happened and the possible consequences help with a speedy recovery.
To prevent future sexual dysfunction, possible fears must be reduced. Sexual practices should be reconsidered and changed. Change of position, the use of other sexual utensils and better arrangements during the act with the sexual partner help. In order for infections or other diseases to develop, attention should be paid to adequate and, above all, sterile wound care.
