Relationship between sexual position and severity of penile fracture


The objective of the study was to evaluate the relationship between the sexual position and severity of penile fracture (PF). We studied 90 patients with PF. The mechanism of injury and the sexual position was assessed. We divided our sample by the etiology of the fracture in six groups: (a) masturbation or penile manipulation; (b) ‘man-on-top’ position; (c) ‘doggy style’ position; (d) ‘woman-on-top’ position; (d) blunt trauma; and (e) ‘rolling over’ fracture. We used the χ2-test for contingency analysis of the populations under study (P<0.05). The patient’s age ranged from 18 to 66 years (mean 39 years). Investigation of the injury mechanism identified sexual trauma as the main etiological factor, involved in 69 cases (76.5%). The sexual position at the time of injury varied, with 23 cases (25.5%) occurring in the ‘man-on-top’, 37cases (41%) in the ‘doggy style’ and 9 cases (10%) in the ‘woman-on-top’. We do not observe differences between the severity of the PF between the ‘doggy style’ and ‘man-on-top’ (P=0.9595), but the ‘doggy style’ had more severity of PF when compared with ‘woman-on-top’ (P=0.0396) and penile manipulation (P=0.0026). The ‘man-on-top’ and ‘doggy style’ positions showed more associations with bilateral fractures of the corpus cavernosum and urethral lesions.

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  1. 1

    Muentener M, Suter S, Hauri D, Sulser T . Long-term experience with surgical and conservative treatment of penile fracture. J Urol 2004; 172: 576–579.

    Article  Google Scholar 

  2. 2

    Morey AF, Dugi DD III . Genital and lower urinary trauma. In: Kavoussi LR, Novick AC, Partin AW, Graig AP (eds). Campbell-Walsh Urology, 10th edn. WB Saunders: Philadelphia, PA, USA, 2012, pp 2507–2508.

    Google Scholar 

  3. 3

    Moslemi MK . Evaluation of epidemiology, concomitant urethral disruption and seasonal variation of penile fracture: a report of 86 cases. Can Urol Assoc J 2013; 7: 9–10.

    Article  Google Scholar 

  4. 4

    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 

  5. 5

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

    CAS  Article  Google Scholar 

  6. 6

    Zargooshi J . Penile fracture in Kermanshah, Iran: report of 172 cases. J Urol 2000; 164: 364–366.

    CAS  Article  Google Scholar 

  7. 7

    Mydlo JH, Hayyeri M, Macchia RJ . Urethrography and cavernosography imaging in a small series of penile fractures: a comparison with surgical findings. Urology 1998; 51: 616–619.

    CAS  Article  Google Scholar 

  8. 8

    Murray KS, Gilbert M, Ricci LR, Khare N, Broghammer J . Penile fracture and magnetic resonance imaging. Int Braz J Urol 2012; 38: 287–288.

    Article  Google Scholar 

  9. 9

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

    Article  Google Scholar 

  10. 10

    Hatzichistodoulou 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; 10: 1424–1430.

    Article  Google Scholar 

  11. 11

    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; 7: 252–257.

    Article  Google Scholar 

  12. 12

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

    Article  Google Scholar 

  13. 13

    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 

  14. 14

    Pavan N, Tezzot G, Liguori G, Napoli R, Umari P, Rizzo M et al. Penile fracture: retrospective analysis of our case history with long-term assessment of the erectile and sexological outcome. Arch Ital Urol Androl 2014; 86: 359–370.

    Article  Google Scholar 

  15. 15

    Reis LO, Cartapatti M, Marmiroli R, de Oliveira EJ Jr., Saade RD, Fregonesi A . Mechanisms predisposing penile fracture and long-term outcomes on erectile and voiding functions. Adv Urol 2014; 2014: 768158.

    PubMed  PubMed Central  Google Scholar 

  16. 16

    Amer T, Wilson R, Chlosta P, AlBuheissi S, Qazi H, Fraser M et al. Penile Fracture: a meta-analysis. Urol Int 2016; 96: 315–329.

    Article  Google Scholar 

  17. 17

    Taha SA, Sharayah A, Kamal BA, Salem AA, Khwaja S . Fracture of the penis: surgical management. Int Surg 1988; 73: 63–64.

    CAS  PubMed  Google Scholar 

  18. 18

    Tijani KH, Ogo CN, Ojewola R, Akanmu NO . Increase in fracture of the penis in south-west Nigeria. Arab J Urol 2012; 10: 440–444.

    Article  Google Scholar 

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Correspondence to L A Favorito.

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Barros, R., Schulze, L., Ornellas, A. et al. Relationship between sexual position and severity of penile fracture. Int J Impot Res 29, 207–209 (2017).

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