PENILE FRACTURE - DIFFERENTIAL-DIAGNOSIS, MANAGEMENT AND OUTCOME

Objective To determine the value of a diagnostic and therapeutic appro ach for patients presenting with acute penis and the effects of this m anagement on the outcome. Patients and methods The study comprises 21 consecutive patients (mean age 33.3 years, range 19-53) who presented with acute penis (acute pain and swelling during and soon after interc ourse). The mean interval between the accident and the treatment was 6 h (range 2-20). All patients initially underwent cavernosography, fol lowed by surgical exploration. Results Cavernosography showed extravas ation of the contrast medium, indicating a corporal tear, in 19 of 21 patients. Surgical exploration revealed rupture of the deep dorsal vei n in two patients whose radiological examinations were normal, In the remaining 19 patients, corporeal tears were repaired. The mean follow- up was 26.7 months; all patients regained penile function (potency). P enile curvature was the only adverse effect in three of the 21 patient s, all of whom presented for medical treatment relatively late after t he initial accident. Conclusion In the management of the acute penis, cavernosography should be performed first and the treatment policy sho uld be determined from the radiological findings. Conservative therapy should be chosen only when the corporeal bodies are intact.