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A. Fracture of the penis, faux pas du coit, is defined as a traumatic rupture of the tunica albuginea of one or both of the corpora cavernosa affecting the erect penis. The rupture may extend to affect the corpus spongiosum and the urethra.
A. The condition is under-reported, and not as rare as has been claimed. The injury most commonly occurs during vigorous sexual intercourse when the penis slips out of the vagina, hitting the perineum or the pubic symphysis. Most coital fractures involve consensual heterosexual vaginal intercourse.
Injury to the penis during sexual intercourse is unusual but the erect penis can be damaged in several ways:
A. The diagnosis of penile fracture can usually be made solely on clinical grounds, with history taking and physical examination. Where the history indicates a possible injury but the physical examination findings are equivocal, imaging studies may be used. Ultrasound Doppler is used for the detection and evaluation of the exact site of the tear. Magnetic resonance imaging is the most accurate modality for evaluating patients with acute penile trauma.
A. Repair of the erectile tissue of the penis or re-attachment of the suspensory ligament of the penis for damage occurring during sexual activity. This should be done as soon as possible, as delayed repair may lead to permanent damage like erectile dysfunction.
A. Observation, ice packs and compression. However, this is not recommended.
A. You will usually have been admitted to hospital as an emergency. Surgery is required on a semi-urgent basis.
A pre-medication will normally be prescribed by the anaesthetist one to two hours before the surgery; this will make you dry-mouthed and pleasantly sleepy.
Please be sure to inform your urologist in advance of your surgery if you have any of the following:
A. Either a full general anaesthetic (where you will be asleep throughout the procedure) or a spinal anaesthetic (where you are awake but unable to feel anything from the waist down) will be used. All methods minimise pain; your anaesthetist will explain the pros and cons of each type of anaesthetic to you. Local anaesthetic infiltration is often used to relieve discomfort after the operation. The actual procedure performed will depend on the type of injury:
A. If you have undergone repair of a “fractured” penis, it is normal to leave a bladder catheter in place for 24 to 48 hours after the procedure. This is removed before you go home.
In the rare event of the urethra (water pipe) being damaged as well, you will need to keep your catheter for 10 to 14 days.
You may experience discomfort for a few days after the procedure but painkillers will be given to you to take home. Absorbable stitches are normally used which do not require removal.
The average hospital stay is three days.
A. Most procedures have a potential for side effects. You should be reassured that, although all these complications are well recognised, the majority of patients do not suffer any problems after a urological procedure.
Common (greater than one in 10)
Occasional (between one in 10 and one in 50)
Rare (less than one in 50)
A. When you leave hospital, you will be given a discharge summary of your admission. This holds important information about your inpatient stay and your operation.
Most patients feel tired and below par for a week or two because this is major surgery.
It will be at least 14 days before healing occurs and you may return to work when you are comfortable enough. You should refrain from sexual intercourse for a minimum of six weeks to allow complete healing.
A. There will be marked swelling of the penis after a few days. This will last up to 10 days and will then subside but do not be alarmed because this is expected. If you develop a temperature, increased redness, throbbing or drainage at the site of the operation, please contact your urologist.
A. you will be asked to follow up in OPD around 3 to 4 days after discharge. A follow up outpatient appointment will be arranged for you some six to eight weeks after the operation.