Factors affecting complications and outcomes in penile fractures: a decade of surgical experience from a single center.

Abstract

Background: Penile fracture (PF) is a urological emergency that can lead to significant complications if not treated promptly and understanding the factors influencing complications and outcomes in PFs is crucial for improving patient management.

Aim: This study aims to evaluate the impact of various factors on postoperative complications and outcomes in patients with PFs based on 10 years of experience at a single center.

Methods: In this retrospective study, we analyzed data from 106 patients who underwent surgical treatment for PFs between 2013 and 2023 at our institution. Patient demographics, fracture characteristics, and postoperative outcomes were analyzed. Factors affecting complications including the timing of surgery, defect size were evaluated.

Outcomes: The study revealed that early surgical intervention significantly reduced the risk of complications. Factors such as larger defect size and delayed surgery were associated with higher rates of postoperative complications.

Results: The mean age of the participants was 46.3 ± 13.9 years. The primary causes of PFs were sexual intercourse (62.3%), masturbation (19.8%), forced penile bending (11.3%), rolling over in bed (4.7%), and falling from bed (1.8%). The mean time from trauma to surgery was 10.5 ± 8 hours, with a mean defect size of 12.7 ± 5.5 mm. Postoperative complications included penile curvature, palpable plaques, and painful erections, with rates of 10.4%, 39.6%, and 23.6%, respectively. International Index of Erectile Function (IIEF-5) scores significantly decreased from preoperative (21.36 ± 2.9) to postoperative values at 6 months (19.48 ± 3.7) (P < 0.001). The time from trauma to surgery significantly correlated with the change in IIEF-5 scores between preoperative and postoperative values (P = 0.007, R ² = 0.067). The group experiencing complications exhibited a mean defect size of 14.54 ± 6 mm, whereas the non-complication group had a mean defect size of 11.07 ± 4.5 mm (P < 0.001).

Clinical implications: The findings suggest that timely surgical intervention and careful assessment of defect size are critical in managing PFs and these insights can guide urologists in optimizing treatment strategies and improving patient outcomes.

Strengths and limitations: This study benefits from a substantial sample size and a decade of surgical experience at a single center. However, the study's retrospective design and unknown patient history with erectogenic drugs are limitations.

Conclusion: The timing of surgery significantly impacts IIEF-5 scores, while the size of the defect was associated with other postoperative complications; understanding the factors influencing complications in PFs can improve surgical outcomes.