The effect of a penile fracture on ejaculatory and erectile functions: A cross-sectional study

Abstract

Background/Aim: There is not enough data in the literature about ejaculatory and erectile functions after a penile fracture. We aimed to report the post-fracture ejaculatory and erectile function change and their relationship with the psychological condition of the patient. Methods: We retrospectively evaluated 27 patients with a penile fracture who were treated surgically. Pre-fracture and post-fracture ejaculatory and erectile functions were evaluated with Intravaginal Ejaculation Latency Time (IELT) and International Index of Erectile Function (IIEF) questionnaires. The psychological conditions of the patients after the fracture were evaluated with the Beck depression score. Results: The mean IELT was increased after penile fracture (P=0.007). The post-fracture and pre-fracture IIEF scores were similar (P=0.062). There was a positive correlation between Beck depression score and post-fracture IELT (r=0.498; P=0.008). Conclusions: According to our results, ejaculation time was longer after penile fractures. It may be related to neurogenic damage due to trauma or the post-fracture psychological condition. However, larger studies with long-term outcomes may reveal the relationship more thoroughly.

Keywords

• Penile fracture
• Ejaculation time
• Erectile Dysfunction
• Depression

Kaynakça

1. 1. Koifman L, Barros R, Júnior RA, Cavalcanti AG, Favorito LA. Penile fracture: diagnosis, treatment, and outcomes of 150 patients. Urology. 2010 Dec;76(6):1488-92. doi: 10.1016/j.urology.2010.05.043. Epub 2010 Aug 12. PMID: 20708223.
2. 2. Gelbard MK. Fractured penis: diagnosis and management--a comment. J Sex Med. 2010 Jun;7(6):2288. doi: 10.1111/j.1743-6109.2010.01813.x. Epub 2010 Apr 26. PMID: 20456633.
3. 3. Kamdar C, Mooppan UM, Kim H, Gulmi FA. Penile fracture: preoperative evaluation and surgical technique for optimal patient outcome. BJU Int. 2008 Dec;102(11):1640-4; doi: 10.1111/j.1464-410X.2008.07902.x. Epub 2008 Aug 14. PMID: 18710448.
4. 4. Ateyah A, Mostafa T, Nasser TA, Shaeer O, Hadi AA, Al-Gabbar MA. Penile fracture: surgical repair and late effects on erectile function. J Sex Med. 2008 Jun;5(6):1496-502. doi: 10.1111/j.1743-6109.2007.00769.x. Epub 2008 Feb 4. PMID: 18266649.
5. 5. 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 Apr;6(4):1141-1150. doi: 10.1111/j.1743-6109.2008.01117.x. Epub 2008 Dec 4. PMID: 19138357.
6. 6. Haas CA, Brown SL, Spirnak JP. Penile fracture and testicular rupture. World J Urol. 1999 Apr;17(2):101-6. doi: 10.1007/s003450050114. PMID: 10367369.
7. 7. Yapanoglu T, Aksoy Y, Adanur S, Kabadayi B, Ozturk G, Ozbey I. Seventeen years' experience of penile fracture: conservative vs. surgical treatment. J Sex Med. 2009 Jul;6(7):2058-63. doi: 10.1111/j.1743-6109.2009.01296.x. Epub 2009 Apr 28. PMID: 19453898.
8. 8. Penbegul N, Bez Y, Atar M, Bozkurt Y, Sancaktutar AA, Soylemez H et al. Ozen S. No evidence of depression, anxiety, and sexual dysfunction following penile fracture. Int J Impot Res. 2012 Jan-Feb;24(1):26-30. doi: 10.1038/ijir.2011.42. Epub 2011 Sep 15. PMID: 21918532.

9. 9. Eke N. Fracture of the penis. Br J Surg. 2002 May;89(5):555-65. doi: 10.1046/j.1365-2168.2002.02075.x. PMID: 11972544.
10. 10. Barros R, Lacerda G, Schul A, Ornellas P, Koifman L, Favorito LA. Sexual complications of penile fracture in men who have sex with men. Int Braz J Urol. 2018 May-Jun;44(3):550-554. doi: 10.1590/S1677-5538.IBJU.2017.0520. PMID: 29493183; PMCID: PMC5996807.
11. 11. Cappelleri JC, Rosen RC, Smith MD, Mishra A, Osterloh IH. Diagnostic evaluation of the erectile function domain of the International Index of Erectile Function. Urology. 1999 Aug;54(2):346-51. doi: 10.1016/s0090-4295(99)00099-0. PMID: 10443736.
12. 12. Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatry. 1961 Jun;4:561-71. doi: 10.1001/archpsyc.1961.01710120031004. PMID: 13688369.
13. 13. Serefoglu EC, Cimen HI, Ozdemir AT, Symonds T, Berktas M, Balbay MD. Turkish validation of the premature ejaculation diagnostic tool and its association with intravaginal ejaculatory latency time. Int J Impot Res. 2009 Mar-Apr;21(2):139-44. doi: 10.1038/ijir.2008.58. Epub 2008 Nov 20. PMID: 19020523.
14. 14. Bolat MS, Özen M, Önem K, Açıkgöz A, Asci R. Effects of penile fracture and its surgical treatment on psychosocial and sexual function. Int J Impot Res. 2017 Nov;29(6):244-249. doi: 10.1038/ijir.2017.31. Epub 2017 Oct 19. PMID: 29047457.
15. 15. Boncher NA, Vricella GJ, Jankowski JT, Ponsky LE, Cherullo EE. Penile fracture with associated urethral rupture. Case Rep Med. 2010;2010:791948. doi: 10.1155/2010/791948. Epub 2010 Nov 7. PMID: 21076536; PMCID: PMC2975082.
16. 16. Muentener M, Suter S, Hauri D, Sulser T. Long-term experience with surgical and conservative treatment of penile fracture. J Urol. 2004 Aug;172(2):576-9. doi: 10.1097/01.ju.0000131594.99785.1c. PMID: 15247735.
17. 17. Lee SH, Bak CW, Choi MH, Lee HS, Lee MS, Yoon SJ. Trauma to male genital organs: a 10-year review of 156 patients, including 118 treated by surgery. BJU Int. 2008 Jan;101(2):211-5. doi: 10.1111/j.1464-410X.2007.07265.x. Epub 2007 Oct 8. PMID: 17922859.
18. 18. Tal R, Hall MS, Alex B, Choi J, Mulhall JP. Peyronie's disease in teenagers. J Sex Med. 2012 Jan;9(1):302-8. doi: 10.1111/j.1743-6109.2011.02502.x. Epub 2011 Oct 7. PMID: 21981606.
19. 19. Ralph D, Gonzalez-Cadavid N, Mirone V, Perovic S, Sohn M, Usta M et al. Trauma, gender reassignment, and penile augmentation. J Sex Med. 2010 Apr;7(4 Pt 2):1657-67. doi: 10.1111/j.1743-6109.2010.01781.x. PMID: 20388163.
20. 20. Hatzichristodoulou G, Dorstewitz A, Gschwend JE, Herkommer K, Zantl N. Surgical management of penile fracture and long-term outcome on erectile function and voiding. J Sex Med. 2013 May;10(5):1424-30. doi: 10.1111/jsm.12107. Epub 2013 Feb 27. PMID: 23445526.
21. 21. Nason GJ, McGuire BB, Liddy S, Looney A, Lennon GM, Mulvin DW et al. Sexual function outcomes following fracture of the penis. Can Urol Assoc J. 2013 Jul-Aug;7(7-8):252-7. doi: 10.5489/cuaj.199. PMID: 24032060; PMCID: PMC3758941.
22. 22. Gamal WM, Osman MM, Hammady A, Aldahshoury MZ, Hussein MM, Saleem M. Penile fracture: long-term results of surgical and conservative management. J Trauma. 2011 Aug;71(2):491-3. doi: 10.1097/TA.0b013e3182093113. PMID: 21278611.
23. 23. Reis LO, Cartapatti M, Marmiroli R, de Oliveira Júnior EJ, Saade RD, Fregonesi A. Mechanisms predisposing penile fracture and long-term outcomes on erectile and voiding functions. Adv Urol. 2014;2014:768158. doi: 10.1155/2014/768158. Epub 2014 Apr 13. PMID: 24822062; PMCID: PMC4005103.
24. 24. Tijani KH, Ogo CN, Ojewola RW, Akanmu NO. Increase in fracture of the penis in south-west Nigeria. Arab J Urol. 2012 Dec;10(4):440-4. doi: 10.1016/j.aju.2012.07.004. Epub 2012 Aug 15. PMID: 26558065; PMCID: PMC4442948.