His and Her Health

Most physicians, and I am sure most patients, have no idea that a penis can be fractured—broken. When the penis is erect, firm and rigid and when the spongy, soft tissue of the corpora cavernosum are filled with blood and surrounded by the rigid, sturdy capsule, a sharp blow to the penis can actually cause the rigid capsule of the corpora spongiosum (the mass of tissue surrounding the urethra) to crack and bleed into tissue of the penis. This acute, sudden rise in penile pressure with disruption of the capsule causes excruciating discomfort, swelling and black-and-blue markings.. Surgery is immediately indicated with evacuation of the blood and suturing of the capsule. By doing such, the long-term morbidity and healing with the possibility of erectile dysfunction is certainly diminished.


When does this occur and how?

Obviously, sexual activity can play a role.  Upon penetration, if the vaginal introitus is missed and the penis suddenly hits the thigh or introitus, a rapid rise in pressure can cause disruption of this capsule and fracture of the penis.  Frequently, a loud noise is made at the time of the fracture, as if a bone was cracking.

On occasion, sudden bending of an erect penis in young males awakening in the morning can also lead to a fracture as can an array of trauma accidents. Still, all told, it is a relatively rare occurrence.

Surgery is obviously indicated and usually involves circumscribing the penis, reflecting the skin of the shaft of the penis, evacuating the clots and debris and suturing closed the traumatic injury to the capsule of the corpora cavernosum.   

Erectile dysfunction is certainly a major complication of this injury and should be discussed with your patient prior to surgery. After full healing in 6-8 weeks, use of PDE5 drugs (Viagra, Cialis and Levitra) to help prevent against this problem should be used.

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