Emergency surgical treatment of penile fracture _1

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Emergency surgical treatment of penile fracture

Of: ZHANG Rui-ming, Sun Chao, Wu Xueliang, Min Xinmin, Wang Yin-Huai Penile fracture is a rare, blunt penile injury, we in the period 1993 to 2006, 15 patients were treated, all emergency surgical treatment postoperative follow-up results were satisfactory. Are as follows. Chinese papers League finishing. 1 Materials and Methods 1.1 Clinical data of 15 cases in this group. Aged 21 to 55 years , mean 37 years. 13 cases of married and unmarried in 2 cases. Injury: 13 cases of sexual violence, masturbation is broken in 2 cases. Time from injury to treatment 2 ~ 36h. Typical clinical manifestations are: penile fracture have different levels of noise when, local pain, then subside penis, penis soft; local swelling, skin was black and blue; penis curvature contralateral bias. Urethra in 1 case with blood, difficulty urinating. 1.2 treatment of 15 patients with typical clinical manifestations according to emergency surgery after diagnosis. Epidural anesthesia, routine disinfection of the skin,[link widoczny dla zalogowanych], from about 0.5 ~ 1cm proximal Coronal Department for circumcision incision penile skin and make it flip to the base of the penis, to remove the hematoma, probe and exposed to injury site, complete hemostasis, albuginea rupture with a 1-0 interrupted absorbable suture inverted suture. If associated with cavernous ruptures, with 3-0 absorbable suture. 1 patient with urethral injury, with a 4-0 absorbable suture suture urethral gap accurately. After reset the flip interrupted suture the skin, urinary tract built Foly catheter, appropriate pressure bandage. 2mg every night after oral administration of diethylstilbestrol to prevent penile erection, application of antibiotics to prevent infection. 1 week after removal of the catheter, the catheter is retained urethral injury complicated by 2 weeks. 2 results operation time 30 ~ 75min, an average of 50min. Intraoperative exploration broken parts: penis distal 1 / 3 of the 9 cases, the penis body 1 / 3 of the 5 cases, the penis proximal 1 / 3 in 1. Catheter after removal of the penis were normal urination, wound healing were Ⅰ. The average hospital stay was 7 days. Married 13 patients 4 weeks after a normal sex life. Were followed up for 6 to 12 months, no penile deformity, cavernous fibrosis, painful nodules, urethral stricture, sexual dysfunction and other complications. Married couples on the hardness and duration of erection is satisfied. 3 Discussion penile fracture is the erection of the penis in the case of the external force caused by the direct rupture of the tunica albuginea and cavernous, about 20% of patients with urethral injury [1] . Cavernosum albuginea is a layer of fibrous membrane, the thickness of 1 ~ 2mm, tough and elastic, when the penis is erect, its thinner, is 0.25 ~ 0.5mm, and loss of elasticity, fragility, so the penis during intercourse or masturbation , etc. erection of violence prone to break under the [2]. The 13 cases occurred during sexual intercourse. 1 with a urethral injury, urethral injury rate was 7.7%.