The penis is composed of erectile tissues that allow the penis to erect during sexual stimulation. It does not contain bones as others may think. Fracture is a term to the presence of injury or discontinuation in the integrity of the bones. Despite it, penile fracture still happens. The term fracture is associated with the rupture of the tunica albuginea, which surrounds the corpus cavernosum. This is responsible for holding the penis erect when blood flows to the area during erection.
The cause of broken penis is primarily related to blunt injury. The most common of this is sexual intercourse accounting up to 50% of cases. When the woman is on top during the sexual intercourse, the tendency is that there is a great impact on the penis from the perineum and pelvic bone. Lateral bending of the penis is also a factor. Another cause of penile fracture during intercourse is the reverse cow girl position, which causes bending the penis ventrally beyond the flexibility of the tunica and causing a break on the tunica albuginea. Other cultural practices also involve the popping of the penis similar to the popping of the knuckles, which also breaks the integrity of the soft tissues.
Symptoms of penile fracture include a cracking or popping sound during the break with sudden severe pain, hematoma formation on the penis and immediate flaccidity to the erect penis. There is only an S-shaped deformity to the organ. Hematoma formation maybe gross if severe tear is involved causing bruising on the scrotum and lower abdomen.
Diagnosis of penile fracture is made by physical examination and imaging studies. Often, an MRI or cavernosography confirms the presence of a tear on the tunica albuginea in the corpus cavernosum.
The presence of penile fracture is considered a medical emergency because it can cause necrosis to the penis once blood flow has ceased. Treatment include surgical repair of the broken penis. Complications increase when non-surgical managements are employed. Treatments focus on preserving the erectile function of the penis, its length and preventing severe necrosis that would warrant amputation.
Complications of penile fracture include
- permanent erectile dysfunction because of the break in the erectile tissues.
- There will also be possible penile curvature that causes painful sexual intercourse.
- The curvature in the penis may affect the urine flow in the urethra, causing urinary tract infections and painful urination.