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Penile fracture: rare, but mostly need surgery

Penile fracture: rare, but mostly need surgery

Treatment within 24 hours can prevent long-term complications like erectile dysfunction and curvature of the penis

Penile fractures are rare in men, but mostly need surgery

It goes without saying that taking care of the male external organs — include the scrotum, urethra and penis – is vital for men. One injury to watch out for is penile fracture.

Experts say a penile fracture can occur due to accidents, untoward incidents harming the penis and extreme cases of sexual intercourse. The treatment mostly involves surgery.


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Last year a 12-year-old boy was taken to Fortis Hospital in Bengaluru after he had a road accident. The boy had suffered multiple injuries, including to his penis and right testis. But doctors say such cases are only a few in number, and in most cases penile fracture occurs during sexual intercourse.

A penile fracture is not the same as a break in a bone. It involves the traumatic rupture of the corpus cavernosa and the tunica albuginea in an erect penis. The corpus cavernosa is one of the two columns of spongy tissue that runs through the shaft of the penis; it forms most of the penis and has blood vessels that play an important role in erections. Tunica albuginea is a fibrous envelope that extends the length of the corpus cavernosa.

Causes of penile fractures

According to a 2017 article published in the British Medical Journal Case Reports, up to 88.5% of penile fractures occur during sexual intercourse.

“Trauma to an erect penis is the commonest cause,” says Dr Mohan Keshavamurthy, chairman, Renal Sciences Specialty Council, Fortis Hospitals, India. “The reasons can also be due to rigorous masturbation, sleeping prone (lying on your belly) and during taqaandan.

“People who undergo this trauma come to the hospital with a ‘popping’ sensation (a slight sound) — like how you bend your knee and hear a slight sound — a swollen penis or a bent penis. It requires immediate treatment, [preferably] within 24 hours.”

Dr Keshavamurthy adds that if not treated immediately there might be long-term risks like erectile dysfunction, excessive penile curvature or narrowing of the urethra.

How to confirm a penile fracture?

Experts say it is important to know how to identify a penile fracture. Unlike other fractures, there may be a crack in this case but no pain.

Dr Vishnu Vardhan Reddy, a senior urologist at Kamineni Hospitals, Hyderabad, lists five symptoms that point to a penile fracture:

  • A popping or cracking sound when the fracture happens
  • Extreme pain that may or may not continue
  • Immediate loss of erection
  • Bruising and swelling from blood build-up under the skin
  • Blood in the urine or at the tip of the penis.

How to treat penile fractures?

“The time from the injury to presentation in the emergency is important for a good outcome and restoration of potency,” says Dr Keshavamurthy. “Assessment of injury is done by a colour doppler scan of the penis. Surgical treatment depends on the grade of injury to one or both corpus, associated urethral injury and circumferential extent of corporal injury.”

Senior urologist Dr Reddy says, “Penile fractures usually require surgery. The surgeon will use stitches to close the tear. The main goals of treatment are to restore or maintain your ability to have erections and preserve urinary function.”

Typically, a hospital stay of one to three days is needed post-surgery and the injury takes a couple of months to fully heal, he adds.


Penile fractures are an emergency condition where surgery is required. They can occur due to accidents, sexual intercourse or any other untoward incidents hurting the male genitalia. Safe sex, use of lubrication and understanding between sexual partners can prevent penile fractures.

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