Penile Fracture Repair
What is Penile Fracture Repair?
Penile fracture repair is an emergency surgical procedure performed to treat a penile fracture, which occurs when the tough fibrous covering of the erectile tissue, known as the tunica albuginea, tears during an erection. Although there is no actual bone in the penis, the term "fracture" describes this rupture of the tissue.
A penile fracture most commonly occurs during sexual activity but can also result from accidental trauma to an erect penis. Prompt surgical repair is considered the gold standard treatment because it helps preserve erectile function, minimise penile curvature, and reduce the risk of long-term complications.
What are the Benefits of Penile Fracture Repair?
Early surgical treatment offers the best chance of a full recovery and helps reduce the risk of permanent damage.
Benefits include:
- Repairs the torn erectile tissue
- Preserves erectile function
- Reduces the risk of penile curvature
- Minimises long-term pain
- Lowers the risk of erectile dysfunction
- Restores normal penile anatomy
- Shortens recovery compared with delayed treatment
- Reduces the likelihood of future complications
When is Penile Fracture Repair Recommended?
Penile fracture repair is recommended as soon as possible after the injury occurs.
Surgery is generally advised when a patient experiences:
- A sudden cracking or popping sound during an erection
- Immediate loss of erection
- Severe penile pain
- Rapid swelling and bruising of the penis
- Penile deformity or bending
- Blood at the tip of the penis
- Difficulty passing urine if the urethra is also injured
Penile fracture is considered a urological emergency, and prompt assessment is essential. Delaying treatment increases the risk of complications, including erectile dysfunction and permanent penile curvature.
What does Preparation for Penile Fracture Repair Involve?
Because penile fracture is an emergency, preparation is focused on confirming the diagnosis and proceeding to surgery without unnecessary delay.
Preparation may include:
- Medical history and physical examination
- Assessment of the mechanism of injury
- Blood and urine tests
- Ultrasound or MRI if the diagnosis is uncertain
- Evaluation for possible urethral injury
- Discussion of the procedure and potential risks
- Fasting before general anaesthetic where possible
In many cases, the diagnosis can be made based on the patient's symptoms and physical examination alone.
How is Penile Fracture Repair Performed?
Penile fracture repair is performed under general or regional anaesthetic and usually takes between one and two hours.
The surgeon makes an incision to expose the injured area, often using a circumferential incision below the head of the penis that allows the skin to be gently rolled back for full visualisation of the erectile tissue. The accumulated blood clot is carefully removed so the tear in the tunica albuginea can be clearly identified.
The torn edges of the tunica are then repaired using strong absorbable sutures to restore the normal structure of the erectile body. The surgeon carefully inspects the penis for any additional tears, as multiple injuries can occasionally occur.
If there is evidence of a urethral injury, such as blood at the urethral opening or difficulty passing urine, the urethra is examined and repaired during the same operation when necessary.
Once the repair is complete, the incision is closed, a dressing is applied, and a urinary catheter may be left in place temporarily if the urethra has also been repaired.
What to Expect during Recovery after Penile Fracture Repair?
Most patients remain in hospital overnight or are discharged the same day, depending on the extent of the injury.
During recovery, you may experience:
- Mild to moderate pain and swelling
- Bruising that gradually fades over several weeks
- Temporary discomfort during erections
- Avoidance of sexual activity for approximately six to eight weeks
- Gradual return to normal daily activities within one to two weeks
- Follow-up appointments to monitor healing and erectile function
Your surgeon may prescribe medication to reduce unwanted erections during the early stages of healing if considered appropriate.
Most men regain normal sexual function when prompt surgical repair is performed.
What are the Risks and Complications of Penile Fracture Repair?
Penile fracture repair is highly successful when performed promptly, but, like all surgery, it carries some potential risks.
Possible complications include:
- Bleeding
- Infection
- Wound healing problems
- Penile curvature during erection
- Erectile dysfunction
- Pain during erections
- Scar tissue formation
- Altered penile sensation
- Urethral stricture if the urethra was injured
- Persistent deformity requiring further treatment
- Anaesthetic-related complications
Your urologist will explain the nature of your injury, discuss the expected benefits and possible risks of surgery, and provide detailed guidance on recovery to maximise healing and help preserve normal urinary and sexual function.