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Penile fracture: what is it?

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A penile fracture, caused by blunt trauma or wear and tear, is a tear in the tunica albuginea, which can severely limit sexual intercourse. Surgery is the recommended treatment, as delaying surgery can lead to medical complications and psychological problems.

A penile fracture is a tear in the tunica albuginea, the group of tissue that surrounds the two cavernous bodies of the penis. These two structures are essential for maintaining an erection; as such, a penile fracture can severely limit an individual’s ability to perform sexual intercourse. The most common cause of this injury is blunt trauma, although wear and tear over time can contribute to its occurrence. Treatment usually involves surgery and a strict set of guidelines to follow after the procedure. Left untreated, a penile fracture can lead to medical complications and psychological problems.

The two structures involved in a penile fracture, the corpus cavernosum penis and the tunica albuginea, play vital roles in a man’s sexual health. The corpus cavernosum is the group of elastic erectile tissue that contains blood that flows to the penis during arousal, resulting in an erection. The tunica albuginea, on the other hand, contains Buck’s fascia, a structure that narrows around the main dorsal vein of the penis, preventing blood from flowing out and subsequently maintaining an erection. Damage to the tunica albuginea can weaken its ability to hold blood in the corpora cavernosa, resulting in sexual dysfunction.

Blunt trauma is the cause of most cases of penile fracture. A sudden, powerful blow to the penis can cause a tear in the tunica albuginea. This most commonly occurs when the patient is in an aroused state and is struck on the penis in such a way that it bends abnormally; fractures usually occur during excessively rough intercourse or physical accidents affecting the penis. Constant penile abuse can also weaken the tunica albuginea, making it more prone to serious damage.

Individuals experience intense pain at the onset of a penile fracture. In many cases, patients report hearing an audible snap, as if a bone had broken. This is probably due to tissue rupture, accompanied by the sudden leakage of blood from the corpora cavernosa. The penis becomes flaccid almost immediately, and the pain and discomfort persist long after the injury. Blemishes caused by internal bleeding may appear on the skin.

Although some individuals recommend nonsurgical penile fracture treatment, often with the use of splints, many physicians recommend treating the injury as a medical emergency requiring immediate surgery. Up to 50% of nonsurgical procedures to repair a penile fracture result in complications, including permanent sexual dysfunction, penile disfigurement, and further internal damage. Patients who delay penile fracture surgery might also experience anxiety and depression issues involving the injury and its effects.

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