Erectile and ejaculatory outcomes after penile fracture repair: a comparative analysis of absorbable vs non-absorbable sutures.

Abstract

This study aimed to compare the effects of absorbable and non-absorbable sutures on postoperative erectile function, ejaculatory function and sexual satisfaction in patients undergoing penile fracture repair. In this single-center retrospective cohort study, 90 patients who underwent surgical treatment for penile fracture between 2020 and 2024 were included. Patients were grouped by suture type, with absorbable sutures used in 53 patients (58.9%) and non-absorbable sutures used in 37 patients (41.1%). Functional outcomes were assessed using the International Index of Erectile Function-5, intravaginal ejaculatory latency time and Index of Sexual Satisfaction at baseline and at 6 and 12 months postoperatively. Baseline characteristics and functional scores were similar between groups. In the absorbable suture group, median International Index of Erectile Function-5 scores showed a statistically significant change at 6 months compared to baseline (24 (IQR: 23 - 26) vs. 24 (IQR: 23 - 25); p = 0.021), but no significant difference was observed at 12 months (24 (IQR: 23 - 25); p = 0.069). In the absorbable group, median intravaginal ejaculatory latency time showed a statistically significant change from baseline at both 6 months (240 (IQR: 180 - 300) vs. 240 (IQR: 200 - 300); p = 0.011) and 12 months (240 (IQR: 180 - 300) vs. 240 (IQR: 205 - 300); p = 0.006). In the non-absorbable group, median intravaginal ejaculatory latency time increased from 240 (IQR: 180 - 330) to 300 (IQR: 200 - 360) at 6 months (p = 0.023) and remained at 300 (IQR: 240 - 360) at 12 months (p = 0.026). Palpable penile nodules were more frequent in the non-absorbable group (24.3% vs. 3.8%; p = 0.006). Early postoperative changes in erectile function were minimal and long-term erectile, ejaculatory and sexual satisfaction outcomes were comparable between absorbable and non-absorbable sutures. Non-absorbable sutures are linked to more palpable nodules. These findings may help guide suture selection.