Penile fracture injury: diagnosis, outcome and long-term follow-up in a Cameroon-based population

Abstract

Background: The incidence of penile fracture is increasing in sub-Saharan Africa. However, it varies considerably among different geographical areas. Early diagnosis and surgery are central to preventing complications such as erectile dysfunction.

Objectives: This study aims to present the outcomes and long-term follow-up of patients with penile fractures in Cameroon.

Materials and methods: This was a retrospective review of 16 consecutive patients who underwent primary surgical repair following penile fracture between 2012 and 2020. All the patients included were treated at the Yaoundé Central Hospital and followed up for at least six months postoperatively. The mechanism of injury, clinical, paraclinical, and surgery details are presented. The International Index of Erectile Function (IIEF-5) score was used to evaluate erectile function.

Results: A total of 16 patients were enrolled with a mean age of 35 ± 1.65 years. The most common cause of injury was vigorous sexual intercourse in 75% of patients (n = 12/16). The “woman-on-top” position occurred in six cases. Ultrasound showed unilateral injury of the corpus cavernosum in 80% of the patients. The location of injury was found in the proximal penis in 87.5% of the study population (n = 14/16). Corpora cavernosa injuries were repaired with simple sutures using 3-0 Vicryl through a sub-coronal approach. The IIEF-5 score 12 months after penile fracture was 23 ± 1.13 (range 22–25).

Conclusion: Early clinical and ultrasound diagnosis of penile fractures associated with prompt surgical management through a subcoronal approach offers a good prognosis with preservation of erectile function.