Penil fraktürde cerrahi ve konservatif izlem sonuçları: tek merkez deneyimi

Year 2022, Volume: 47 Issue: 4, 1650 - 1655, 28.12.2022

Yusuf Kasap Kazım Ceviz Muhammed Emin Polat Lütfi İhsan Boyacı Mecit Çelik Samet Şenel Emre Uzun

https://doi.org/10.17826/cumj.1139262

Abstract

Purpose: The aim of this study was to show that surgical treatment ıf penile fracture (PF) is more advantageous than conservative treatment in terms of complications, but those complications can be seen after surgery also, even may be serious enough to require surgery for a second time.
Materials and Methods: The data of 31 patients diagnosed with PF between 05.04.2019 and 28.07.2021 were evaluated retrospectively. Three patients were excluded from the study because their data could not be accessed. 21 patients who underwent PF repair were determined as group 1 and 7 patients who were followed conservatively because they did not want surgery, as group 2. Causes of PF, admission time to the emergency department, and ultrasonographic (USG) imaging were analyzed. All patients were evaluated with the IIEF-15 form at the sixth month of surgery or conservative treatment. In addition, penile nodules and curvature were evaluated in terms of painful erection after the operation.
Results: The median age for Group 1 was 43±14.52 and 47±14.71 for Group 2. Tunica defect was 7.02±3.26 for group 1 patients and 6.85±4.98 for group 2. When the presence of complications and sexual dysfunction were compared between the two groups, it was found that Group 2 developed significantly more complications and caused more sexual dysfunction.
Conclusion: The treatment of PF with fewer complications is surgical treatment, but it should not be forgotten that surgical treatment may cause complications requiring a second surgical intervention.

Keywords

Tunica defect, sexual dysfunction, tunica albuginea

Supporting Institution

Yoktur.

Project Number

Yoktur.

Thanks

Yoktur.

Surgical and conservative treatment results of penile fracture: single-center experience

Abstract

Amaç: Bu çalışmada penil fraktürde cerrahi tedavinin komplikasyon olarak daha avantajlı olduğu ancak cerrahi sonrasında da özellikle ikinci kez cerrahi gerektirecek kadar ciddi komplikasyonların görülebileceğini göstermek amaçlandı.
Gereç ve Yöntem: 05.04.2019 ve 28.07.2021 tarihleri arasında penil fraktür tanısı konulan 31 hastanın verileri retrospektif olarak değerlendirildi. 3 hasta verilerine ulaşılamaması nedeni ile dışlandı. Penil fraktür onarımı yapılan 21 hasta grup 1 ve cerrahi istemediğinden konservatif olarak izlenen 7 hasta grup 2 olarak iki gruba ayrıldı. Penil fraktür nedenleri, acil servise başvuru süreleri, ultrasonografik (USG) görüntülemeleri incelendi. Tüm hastalar cerrahi veya konservatif tedavinin altıncı ayında IIEF-15 formu ile değerlendirildi. Ayrıca operasyondan sonra penil nodül ve kurvatür, ağrılı ereksiyon açısından değerlendirildi.
Bulgular: Grup 1 için median yaş 43±14,52 Grup 2 için 47±14,71 idi. Grup 1 hastalar için tunika defekti 7,02±3,26, grup 2 için 6,85±4,98 idi. İki grup arasında komplikasyon ve erektil disfonkisyon (ED) varlığı karşılaştırıldığında Grup 2 de anlamlı olarak daha fazla komplikasyon geliştiği ve daha fazla ED’ ye neden olduğu saptandı.
Sonuç: Penil fraktürün komplikasyon olarak daha az olan tedavisi cerrahi tedavidir ancak cerrahi tedavinin de ikinci kez cerrahi müdahale gerektirecek komplikasyonlara neden olabileceği unutulmamalıdır.

Keywords

Tunica defect, sexual dysfunction, tunica albuginea

Project Number

Yoktur.

References

• 1. Fergany AF, Angermeier KW, Montague DK. Review of Cleveland Clinic experience with penile fracture. Urology 1999; 54:352-355.
• 2. Farah RN, Stiles R, Jr., Cerny JC. Surgical treatment of deformity and coital difficulty in healed traumatic rupture of the corpora cavernosa. J Urol 1978; 120:118-120.
• 3. Hassali M, Nouri A, Hamzah A, et al. Role of penile doppler as a diagnostic tool in penile fracture. Journal of Medical Ultrasound 2018; 26:48-51.
• 4. Al-Shaiji TF, Amann J, Brock GB. Fractured penis: diagnosis and management. J Sex Med 2009; 6:3231-3240; quiz 3241.
• 5. Masarani M. DM. Penile fracture: diagnosis and management. 2007; 12:20-24.
• 6. Mydlo JH. Surgeon experience with penile fracture. J Urol 2001; 166:526-528; discussion 528-529.
• 7. Zargooshi J. Sexual function and tunica albuginea wound healing following penile fracture: An 18-year follow-up study of 352 patients from Kermanshah, Iran. J Sex Med 2009; 6:1141-1150.
• 8. Ateyah A, Mostafa T, Nasser TA, et al. Penile fracture: surgical repair and late effects on erectile function. J Sex Med 2008; 5:1496-1502.
• 9. Hajji F, Ameur A. Butterfly hematoma after traumatic intercourse. Pan Afr Med J 2015; 20:317.
• 10. Saglam E, Tarhan F, Hamarat MB, ve ark. Efficacy of magnetic resonance imaging for diagnosis of penile fracture: A controlled study. Investig Clin Urol 2017; 58:255-260.
• 11. Morey AF, Metro MJ, Carney KJ, et al. Consensus on genitourinary trauma: external genitalia. BJU Int 2004; 94:507-515.
• 12. Uder M, Gohl D, Takahashi M, et al. MRI of penile fracture: diagnosis and therapeutic follow-up. Eur Radiol 2002; 12:113-120.
• 13. Eke N. Fracture of the penis. Br J Surg 2002; 89:555-565.
• 14. Kamdar C, Mooppan UM, Kim H, et al. Penile fracture: preoperative evaluation and surgical technique for optimal patient outcome. BJU Int 2008; 102:1640-1644; discussion 1644.
• 15. Bar-Yosef Y, Greenstein A, Beri A, et al. Dorsal vein injuries observed during penile exploration for suspected penile fracture. J Sex Med 2007; 4:1142-1146.
• 16. Baran C, Topsakal M, Kavukcu E, ve ark. Superficial dorsal vein rupture imitating penile fracture. Korean J Urol 2011; 52:293-294.
• 17. Nicely ER, Costabile RA, Moul JW. Rupture of the deep dorsal vein of the penis during sexual intercourse. J Urol 1992; 147:150-152.
• 18. El-Assmy A, El-Tholoth HS, Abou-El-Ghar ME, et al. Risk factors of erectile dysfunction and penile vascular changes after surgical repair of penile fracture. Int J Impot Res 2012; 24:20-25.
• 19. Hatzichristodoulou G, Dorstewitz A, Gschwend JE, et al. Surgical management of penile fracture and long-term outcome on erectile function and voiding. J Sex Med 2013; 10:1424-1430.
• 20. Bozzini G, Albersen M, Otero JR, et al. Delaying Surgical Treatment of Penile Fracture Results in Poor Functional Outcomes: Results from a Large Retrospective Multicenter European Study. Eur Urol Focus 2018; 4:106-110.
• 21. Yapanoglu T, Aksoy Y, Adanur S, ve ark. Seventeen years' experience of penile fracture: conservative vs. surgical treatment. J Sex Med 2009; 6:2058-2063.