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Risk factors of erectile dysfunction and penile vascular changes after surgical repair of penile fracture

International Journal of Impotence Research volume 24, pages 20–25 (2012)Cite this article

Abstract

This study was conducted to determine the preoperative and intraoperative risk factors of ED and the underlying penile vascular abnormalities among patients with penile fracture treated surgically. In all, 180 patients with penile fracture were treated surgically and followed up in one center. None of our patients had ED before the penile trauma and only two of them had risk factors for systemic vascular diseases, such as diabetes mellitus (one patient) and hypertension (one patient). After a mean follow-up of 106 months, 11 patients (6.6%) developed ED, 7 had mild ED and 4 had moderate ED. The main risk factors for subsequent ED were aging, >50 years, and bilateral corporal involvement. Among the 11 patients with ED, color Doppler ultrasonography (CDU) showed normal Doppler indices in 4 (36.4%), veno-occlusive dysfunction in 4 (36.4%) and arterial insufficiency in the remaining 3 (27.2%) patients. CDU assessments from the injured and intact sides were comparable. ED of either a psychological or vascular origin can be encountered as a long-term sequel of surgical treatment of penile fracture. Aging, >50 years, at presentation and bilateral corporal involvement is the main risk factors for subsequent development of ED.

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References

  1. Shaeer O, Shaeer K . Penile fracture: evaluation and management. In: Carson CC, Kirby RS, Goldstein I, Wyllie MG (eds). Text Book of Erectile Dysfunction, 2nd edn. Informa Healthcare: New York, 2009, pp. 392–397.

    Google Scholar 

  2. Fergany A, Angermeier KW, Montague DK . Review of Cleveland clinic experience with penile fracture. Urology 1999; 54: 352–355.

    Article  CAS  Google Scholar 

  3. De Giorgi G, Luciani LG, Valotto C, Moro U, Praturlon S, Zattoni F . Early surgical repair of penile fractures: our experience. Arch Ital Urol Androl 2005; 77: 103–105.

    PubMed  Google Scholar 

  4. Eke N . Fracture of the penis. Br J Surg 2002; 89: 555–565.

    Article  CAS  Google Scholar 

  5. Koifman L, Cavalcanti AG, Manes CH, Filho DR, Favorito LA . Penile fracture-experience in 56 cases. Int Braz J Urol 2003; 29: 35–39.

    Article  Google Scholar 

  6. Zargooshi J . Penile fracture in Kermanshah, Iran: the longterm results of surgical treatment. BJU Int 2002; 89: 890–894.

    Article  Google Scholar 

  7. Ibrahiem EH, El-Tolth H, Mohsen T, Hekal I, El-Assmy A . Penile fracture: long term outcome of immediate surgical intervention. Urology 2010; 75: 108–111.

    Article  Google Scholar 

  8. Koifman L, Barros R, Júnior RA, Cavalcanti AG, Favorito LA . Penile fracture: diagnosis, treatment and outcomes of 150 patients. Urology 2010; 76: 1488–1492.

    Article  Google Scholar 

  9. Grima F, Paparel P, Devonec M, Perrin P, Caillot JL, Ruffion A . Management of corpus cavernosum trauma. Prog Urol 2007; 16: 12–18.

    Google Scholar 

  10. Hinev A . Fracture of the penis: treatment and complications. Acta Med Okayama 2000; 54: 211–216.

    CAS  PubMed  Google Scholar 

  11. Penson DF, Seftel AD, Krane RJ, Frohrib D, Goldstein I . The hemodynamic pathophysiology of impotence following blunt trauma to the erect penis. J Urol 1992; 148: 1171–1180.

    Article  CAS  Google Scholar 

  12. Mansi MK, Emran M, el-Mahrouky A, el-Mateet MS . Experience with penile fractures in Egypt: long-term results of immediate surgical repair. J Trauma 1993; 35: 67–70.

    Article  CAS  Google Scholar 

  13. Nane I, Tefekli A, Armagan A, Sanli O, Kadioglu A . Penile vascular abnormalities observed long-term after surgical repair of penile fractures. Int J Urol 2004; 11: 316–320.

    Article  Google Scholar 

  14. El Atat R, Sfaxi M, Benslama MR, Amine D, Ayed M, Mouelli SB et al. Fracture of the penis: management and long-term results of surgical treatment. Experience in 300 cases. J Trauma 2008; 64: 121–125.

    Article  Google Scholar 

  15. 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; 5: 1496–1502.

    Article  Google Scholar 

  16. Nasser TA, Mostafa T . Delayed surgical repair of penile fracture under local anesthesia. J Sex Med 2008; 5: 2464–2469.

    Article  Google Scholar 

  17. Kamdar C, Mooppan UM, Kim H, Gulmi FA . Penile fracture: preoperative evaluation and surgical technique for optimal patient outcome. BJU Int 2008; 102: 1640–1644.

    Article  Google Scholar 

  18. Mazaris EM, Livadas K, Chalikopoulos D, Bisas A, Deliveliotis C, Skolarikos A . Penile fractures: immediate surgical approach with a midline ventral incision. BJU Int 2009; 104: 520–523.

    Article  Google Scholar 

  19. 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.

    Article  Google Scholar 

  20. Rosen RC, Cappelleri JC, Smith MD, Lipsky J, Peña BM . Development and evaluation of an abridged, 5-item version of the International Index of Erectile Function (IIEF-5) as a diagnostic tool for erectile dysfunction. Int J Impot Res 1999; 11: 319–326.

    Article  CAS  Google Scholar 

  21. O’Donnell AB, Araujo AB, Goldstein I, McKinlay JB . The validity of a single-question self-report of erectile dysfunction. Results from the Massachusetts male aging study. J Gen Intern Med 2005; 20: 515–519.

    Article  Google Scholar 

  22. Patel U, Lees WR . Pharmacological testing: Doppler. In: Carson CC, Kirby R, Goldstein I (eds). Text Book of Erectile Dysfunction, 1st edn. Ibis Medical Media: Oxford, 1999, pp. 31–34.

    Google Scholar 

  23. Asgari MA, Hosseini SY, Safarinejad MR, Samadzadeh B, Bardideh AR . Penile fractures: evaluation, therapeutic approaches and long term results. J Urol 1996; 155: 148–149.

    Article  CAS  Google Scholar 

  24. Cummings JM, Parra RO, Boullier JA . Delayed repair of penile fracture. J Trauma 1998; 45: 153–154.

    Article  CAS  Google Scholar 

  25. Al-Shaiji TF, Amann J, Brock GB . Fractured penis: diagnosis and management. J Sex Med 2009; 6: 3231–3240.

    Article  Google Scholar 

  26. Orvis BR, McAninch JW . Penile rupture. Urol Clin North Am 1989; 16: 369–375.

    CAS  PubMed  Google Scholar 

  27. Feki W, Derouiche A, Belhaj K, Ouni A, Ben Mouelhi S, Ben Slama MR et al. False penile fracture: report of 16 cases. Int J Impotence Res 2007; 19: 471–473.

    Article  CAS  Google Scholar 

  28. Naraynsingh V, Ramdass MJ, Thomas D, Maharaj D . Delayed repair of a fractured penis: a new technique. Int J Clin Pract 2003; 57: 428–429.

    CAS  PubMed  Google Scholar 

  29. Gontero P, Sidhu PS, Muir GH . Penile fracture repair: assessment of early results and complications using color Doppler ultrasound. Int J Impot Res 2000; 2: 125–128.

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Urology, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt

    A El-Assmy, H S El-Tholoth & E H I Ibrahiem

  2. Department of Radiology, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt

    M E Abou-El-Ghar & T Mohsen

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  1. A El-Assmy
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  2. H S El-Tholoth
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  3. M E Abou-El-Ghar
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  4. T Mohsen
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  5. E H I Ibrahiem
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Correspondence to A El-Assmy.

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El-Assmy, A., El-Tholoth, H., Abou-El-Ghar, M. et al. Risk factors of erectile dysfunction and penile vascular changes after surgical repair of penile fracture. Int J Impot Res 24, 20–25 (2012). https://doi.org/10.1038/ijir.2011.41

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  • DOI: https://doi.org/10.1038/ijir.2011.41

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