Sexual function outcomes following penile fracture repair: a case series

BACKGROUND: Penile fracture is arguably a man's worst sexual nightmare. It occurs when there is a tear in the tunica albuginea of the corpora cavernosa. This condition is significantly typified by the late presentation of patients to the hospital due to fear and embarrassment. Although the available literature has fairly elucidated on the aetiology of the disease, very few have objectively evaluated its impact on sexual function. In this series, we examine the impact of these fractures on sexual function after surgical repair using objective erectile function assessment tools. CASE PRESENTATIONS: This case series focused on the impact on sexual function following penile fracture repair at the Korle Bu Teaching Hospital. Data was collected between 1st January and 31st December, 2021. Nine (9) patients were evaluated and managed over the period. The mean age at presentation was 41.11 ± 11.46 years (range 25-61 years).Patient 1, an African male, 61 years of age presented 72 h after sustaining the penile fracture. The second patient, Patient 2, African male, 32 years, presented 48 h after the event. Patient 3, African male, 25 years, presented after 5 h. Other patients, Patient 4, an African male, 41 years, Patient 5, African male, 29 years, Patient 6, African male, 41 years, Patient 7, African male, 41 years, Patient 8, African male, 53 years and Patient 9, African male, 46 years presented 24 h, 9 h, 14 h, 3 h, 12 h and 14 h respectively after the event. Penile fractures were sustained during sexual intercourse (78%), rolling over in bed (11%) and in the case of one patient, it was sustained during a tussle with his wife over sex (11%). The tunica albuginea defect was seen on the right in 7 out of the 9 cases with defect size ranging from 1 cm to 2.5 cm. None of the patients had erectile dysfunction before penile fracture. 4 out of the 9 (44.4%) had no erectile issues post-repair, another 4 (44.4%) experienced mild erectile dysfunction with mild to moderate erectile dysfunction observed in 1 (11.1%) patient. The preponderance of penile fractures were ventrally located, with base of shaft fractures with right laterality being the commonest. CONCLUSION: Penile fractures can negatively affect sexual function, but the extent of the impact is non-dependent on the timing of the repair. The preponderance of penile fractures were ventrally located, with base of shaft fractures coupled with right laterality being the commonest in our setting.