Penile Fracture: What Is It and How to Treat It

Although the penis doesn't technically have bones, it is still possible to "break" or rupture during intimate moments. In medical terms, it is known as a penile fracture.

Read on as we uncover what a penile fracture is, how it happens, and how to maximize your functional outcomes during treatment and recovery.

What is a Penile Fracture?

A penis fracture is a type of injury caused by a rupture of the erectile tissue within the penile shaft. However, the name is misleading because the fracture has nothing to do with an actual bone.

During an erection, the penis is engorged with blood that fills two cylinders within the shaft known as the corpora cavernosa.

When the penis bends suddenly or forcefully, it can cause the outer lining of these cylinders, known as the tunica albuginea, to rupture or tear. That is what is known as a vertical penis fracture.

According to research, vertical penile fractures are relatively rare and occur in only 1 in 175,000 cases seen in urology departments.

Penile Fracture Signs and Symptoms

When a suspected penile fracture occurs, it will begin to swell and appear purple – sort of like an eggplant.

Other common signs and symptoms of a penile fracture include:

• A popping or cracking sound during impact
• Immediate and severe penile pain
• Sudden loss of an erection
• Soreness to the surrounding tissues
• Bent-appearing penis
• Difficulty urinating

How Does a Penile Fracture Happen?

Most penis fractures occur with direct trauma during sexual intercourse. The abnormal bending force that typically happens during sex causes an acute increase in intracavernosal pressures that creates tension on the erectile tissue, resulting in a tear or "fracture".

Although it is possible to experience a penile fracture in other ways (i.e. a sharp blow to the erect penis during a fall or while performing vigorous masturbation), vaginal intercourse is shown to be the number one cause.

One study reported that 57.2% of patients reported experiencing trauma during sex whereby the penis slips out and accidentally thrusts into the pelvis.

Penile Fracture Early Detection and Treatment

A penis fracture is a painful injury that requires immediate medical attention.

Typically, penile fractures are clinically diagnosed using either an ultrasound or magnetic resonance imaging (MRI). Once detected, the majority of cases are recommended for surgical treatment – especially if the trauma has resulted in a concomitant urethral injury.

Your surgeon will use stitches to close the tear in the tunica albuginea and corpus cavernosa to prevent permanent damage to the surrounding tissues.

According to board-certified Urologist Dr. Tony Nimeh, it's important to seek medical care to repair the corpora cavernosa and related structures within 24 hours. Not only does this help improve your chances of restoring erectile function and preserving urinary function, but it will also minimize your risk of developing permanent erectile difficulties later in life.

Penile Fracture Healing Journey

Depending on the severity of the penile fracture, such as if it was a rupture of both cylinders or if it included other injuries, recovery can take up to 6 or more weeks to fully heal.

After surgery, patients are recommended to stay in the hospital for 1-3 days. Once discharged, it's important to avoid any sexual activity that may cause an erection as it is likely to slow the healing process down tremendously – not to mention that it's super painful!

In the months following surgery, you'll be required to check with your doctor for an examination of the veins and arteries in the penis, to assess blood flow, and possibly to take more imaging to track progress and/or discover any potential complications.

Penile Fracture Complications

According to research, surgical interventions were shown to result in positive outcomes in over 90% of cases, with only a few men experiencing side effects, including erectile dysfunction, changes in the curvature of the penis, and painful erections.

In cases where penile fractures caused permanent erectile dysfunction, whether that be due to prolonged surgical repair or experiencing post-treatment complications, there is an option to have a penile prosthesis put in.

During this operation, the surgeon will insert a small balloon filled with saline solution into the shaft of the penis. Although this will not increase sexual desire or physical sensation, it will cause the outside of the penis to become rigid and erect to help improve sexual performance.

FAQs

What is a penile fracture?

When a man is aroused during sexual activity, their penis will become engorged with blood that fills two cylinders within the shaft, also known as the corpora cavernosa. It is what causes an erection. The sudden and forceful bending of an erect penis can rupture the outer lining (tunica albuginea) of one or both cylinders. This rupture is known as a penis fracture.

Can a penile fracture fix itself?

No. Unfortunately, a fracture of the penis rarely heals on its own. Due to the severe pain these types of injuries cause, it's important to seek immediate medical assistance to manage symptoms.

When left untreated, penile fractures can result in a curved penis or potentially permanent damage to the tissue, which can result in permanent erectile dysfunction.

How is a penile fracture treated?

To ensure that full erectile function is restored, prompt surgical repair is highly recommended.

During the procedure, the surgeon will use stitches to close up the tear within the erectile tissue. At this time, the surgeon will also look for other penile trauma injuries, such as a tear in the urethra.

How long does it take to recover from a penile fracture? Typically, a penile fracture takes about 4-6 weeks or even more to heal. Ideally, avoid erections for the full duration of your recovery to avoid complications.