Penile trauma management in absence of fracture: Long-term outcomes

Objective

This study evaluates the clinical outcomes of patients with suspected penile fractures who were managed conservatively after MRI excluded tunica albuginea rupture or fracture.

Methods

A retrospective review was conducted over a seven-year period, identifying patients who presented with symptoms suggestive of penile fracture. All patients who underwent MRI imaging to confirm or exclude the presence of a tunica albuginea rupture. Based on MRI findings, patients without confirmed fractures were managed conservatively, including instructions to avoid sexual activity and strenuous physical exertion. Follow-up assessments were conducted to monitor long-term complications, with a specific focus on erectile function, assessed via the International Index of Erectile Function (IIEF) and penile curvature.

Results

Of the 30 patients with suspected penile fractures, MRI excluded fractures in 63%. Among these conservatively managed patients, approximately 60% developed erectile dysfunction (ED) and 27% developed penile curvature. Even in cases without confirmed fractures, patients with contusions demonstrated significant post-injury complications.

Conclusion

MRI is effective in ruling out penile fractures, supporting the use of conservative management when fractures are not confirmed. However, conservative treatment alone is associated with a notable rate of complications, suggesting the potential benefit of early penile rehabilitation to address functional outcomes in these patients.