A penile rupture, which is a rupture of the corpus cavernosum or the surrounding tissue layer, is a rare but serious injury to the male sex organ. Penile rupture always requires medical attention, and in most cases surgery cannot be avoided to prevent possible long-term consequences such as erectile dysfunction.
What is a penile rupture?
The term penile fracture is misleading, because the so-called penile rupture is not a bone fracture. This is because the penis does not contain a bone. In a penile rupture, there is a tear in the tunica albuginea, the layer of tissue that surrounds the corpus cavernosum of the penis and which helps maintain an erection. The penile corpus cavernosum itself can also become overstretched or even tear. Penile rupture can only occur when the penis is erect, namely when the erect member is bent too much. Penile rupture is relatively rare, but almost always requires medical attention.
Causes
The most common causes of penile rupture are related to vaginal intercourse or masturbation. For example, the penis may kink when it hits the woman’s pelvic bone or perineum. This happens most often when the woman sits on top, on top of the man (“rides””), during intercourse and loses the penis, so that her weight causes the penis to kink. Penile ruptures can also occur when an attempt is made to conceal an erect penis and it is pushed down too hard. Rarely, a man may suffer a penile rupture while sleeping. This can happen if he lies with all his weight on the erect member, causing it to bend sharply. If injuries to the penis occur while the penis is flaccid, for example due to kicks or blows, this does not result in a penile rupture. This injury can only occur during an erection.
Symptoms, complaints and signs
In most cases, a penile rupture expresses itself immediately by a cracking sound in the erect member. There is an abrupt loss of erection (which is a prerequisite for cavernous body rupture) and thus a brief flaccidity of the member. There is immediate severe pain in the torn area of the erectile tissue, which may radiate. The pain may involve the lower abdomen, testicle, and back. One or more swellings occur. Blue and red hematomas appear very quickly and sometimes cause discoloration of the entire limb. Depending on the site of the rupture, the swelling may also involve the pubic bone and testicles. The swelling may result in an unnatural bending of the limb that passes around the intact erectile tissue. Accordingly, the bending usually occurs toward the upper right or upper left, respectively. In some cases, the rupture is palpable and allows the limb to be pressed in at the point of greatest swelling. In rare cases, a rupture of the corpus cavernosum also occurs, allowing blood to leak from the urethra. However, this is a rare symptom of penile rupture.
Diagnosis and course
Diagnosis is made by visual and palpatory findings of the attending physician. The suspected diagnosis is often already established from the history taking. Typically, those affected describe a loud clicking noise. The penis immediately becomes flaccid and the man feels a stabbing pain in the genital area. In addition, a large, dark hematoma can be seen on the swollen penis. This bruise alone usually allows for a simple visual diagnosis. If the urethra has been injured, blood may be found in the urine. In order to diagnose an injury to the urethra, a urethography is performed, i.e. an X-ray of the urethra in which a contrast medium is injected. The further course of this injury depends on the treatment. In general, the prognosis is good. If there is no treatment, this can lead to penile curvature or erectile difficulties.
Complications
Penile rupture entails some complications, which are more common the longer one waits to operate on the affected erectile tissue. It is true that quick action and medical care of the limb and urethra can well prevent arising complications. For example, a penile fracture can result in penile curvature (acquired penile curvature), as the tissue may scar or heal in a compressed form.Such a curvature is primarily an aesthetic problem, but depending on its severity, it can also lead to significant difficulties during sexual intercourse. Urethral stenosis may also occur. It can result from a narrowing of the defective tissue, or it can occur as a result of injury to the urethra during medical treatment. This can cause it to scar. This leads to problems with urination, an increased susceptibility to infections and can cause pain. Urethral stenosis is treatable. If the erectile tissue is irreparably damaged, or if nerve damage is present, erectile dysfunction may occur. The partial or complete loss of erectile function is often a great psychological burden for those affected. There may also be pain when erections occur after surgery. It is possible that these may persist for a long time.
When should you go to the doctor?
If a sound similar to a pop is heard in a man’s intimate area during the sexual act, a penile fracture is often present. A visit to the doctor should be made immediately, because immediately at the same moment severe pain begins in the member. If swelling of the penis occurs and there is an immediate regression of the erection, it is advisable to consult a doctor. Discoloration, bruising, as well as a spread of pain should be presented to a doctor as soon as possible. Due to the numerous risks, side effects and complications, it is advisable to refrain from taking a painkilling medication on one’s own. Medications should be taken only after consulting a medical professional in order to achieve the best possible treatment result. If the fracture site can be palpated on the male member, action is required. In the case of bleeding from the penis, secondary symptoms have developed as a result of the penile fracture. A visit to the doctor is necessary so that there is no increase in further symptoms. Behavioral abnormalities, aggressive tendencies or weepiness are additional signs of a health irregularity. If heart palpitations, disturbances of the heart rhythm as well as clouding of consciousness occur, the affected person needs help. If there is a loss of consciousness, the emergency physician must be alerted. Present persons have the duty to initiate first aid measures in these cases, so that no further impairments or life-threatening conditions occur.
Treatment and therapy
To prevent any complications, it is advisable to see a doctor immediately if a penile injury is suspected. In very many cases, surgery is unavoidable. The faster the operation can be performed, the more promising it will be. Surgery is intended to prevent further functional disorders due to the penile rupture. As a first measure after a penile rupture, cooling the affected area by applying ice is recommended, as this reduces the extent of the swelling. If there is no severe rupture, conservative treatment can be used. This involves applying a pressure bandage and cooling the penis. Since a penile rupture is very painful, painkillers are also given. Furthermore, treatment with medication is given to reduce painful erections. After penile surgery, it is necessary not to have sexual intercourse for at least four weeks, so that the suture can heal well and is not exposed to strong stress.
Outlook and prognosis
A penile rupture that is untreated or treated only conservatively can have significant consequences, depending on its severity. Initially, there is a risk of bacterial infection in the area of the rupture. This can be minimized by administering antibiotics. In addition to persistent pain and swelling, expanding bruises may develop in individual cases. The urethra may also be affected and become narrowed. Blood in the urine is an indicator of this. If such a urethral constriction develops, bladder and kidney problems may subsequently occur. As a long-term consequence of the rupture of the corpus cavernosum, a curvature of the penis (“penile deviation”) is possible. This develops when the tissue heals or scars in a compressed manner. Some men experience erectile dysfunction and even impotence in connection with acquired penile curvature. Penile deviation can also cause pain during subsequent sexual intercourse. If the hernia is operated on promptly, however, the chances of healing without complications are statistically very good.Even later operations, especially after bridging conservative treatment, regularly still lead to good results. Some men report sexual dysfunction despite successful surgery. These can be a temporary psychological consequence of the fact that the penile fracture was experienced as traumatic. Psychotherapeutic treatment can support the path to holistic recovery in this case.
Prevention
Basically, penile ruptures are rare injuries, which mainly result from very vigorous sexual activity. Being aware that something like a penile rupture exists and how it can occur is an important step in preventing injuries. In addition, care should be taken with the penis during sexual intercourse and also during masturbation.
Aftercare
As a rule, no medical aftercare is necessary after a penile fracture. The condition heals well with appropriate rest. Complications and consequences are the exception. A penile fracture can occur again at any time. The male member is always in an excited state. Patients should therefore refrain from excessive movements during pleasure play as part of their aftercare. This will prevent a new rupture. The attending physician will provide information about inappropriate use. The implementation of the recommendations is the responsibility of the affected person. Despite the scientific possibilities, sometimes consequences from a penile fracture remain. These consist of urethral constriction or impotence. These conditions entail the need for further therapies. Organic dysfunctions are best treated surgically. Imaging procedures such as an MRI or CT scan provide information about the extent of the disorder. Erectile dysfunction, on the other hand, is usually associated with psychological causes. If necessary, a doctor can prescribe talk therapy or medication to increase desire. Unlike cancer, a penile fracture does not entail close follow-up. Consequences are rarely to be expected after a complete healing. If they do occur, the conditions must be addressed as part of further treatment.
What you can do yourself
If a penile fracture occurs, an emergency physician must be called or rapid transport to the emergency room must be made. Self-treatment or attempts at self-therapy are not recommended. Supportive of medical care, wearing loose-fitting clothing will help. Tight-fitting underpants or pants intensify existing pain and should not be worn. The buttock area should be protected from foreign object impact. Therefore, pockets of clothing should be emptied so that neither keys nor a cell phone can come into contact with the intimate area through movement. During the healing process, sexual activities of any kind should be avoided. This includes cognitive processes and sexual fantasies. The corpus cavernosum should be relieved and would immediately hurt if sexually stimulated. To avoid erectile dysfunction later on, mental stress should be reduced. An inner calmness in dealing with what has happened and the possible consequences will help in a quick recovery. To prevent future sexual dysfunction, reduce possible anxiety. Sexual practices should be reconsidered and changed. Changes in position, the use of other sexual utensils, and better agreements during the act with the sexual partner help. To prevent infections or further diseases from developing, care should be taken to ensure adequate and, above all, sterile wound care.
