Penile fracture is a rare condition. It is a misnomer as penis does not have a bone. It is the name given to the rupture of a layer called as tunica albuginea (one or both sides). Inside the penis, there are two long sponge like compartments named as corpora cavernosa. Tunica albuginea layer covers corpora cavernosa. Rupture of this layer is known as “broken penis syndrome”, and it mostly occurs in the distal two thirds of the penis. It can either be partial or complete.
One of the causes of penile fracture is due to a blunt force on the erecting penis. Such blunt force can be caused by:
Rigorous hand job
Vaginal intercourse in different positions.
Taghaandan maneuver: It is practiced in Middle East, Africa, Asia. It is purposefully bending of penis during masturbation.
Sex positions that may cause penile fracture include:
Cow girl position (where the woman sits on top of the man while having sex).
Reverse cow girl position
Clinical features of penile fracture include crackling sound or popping sound followed by pain and swelling (due to accumulation of blood—hematoma formation), the also followed by flaccid penis. This occurs typically after a sexual encounter. It also leads to eggplant deformity of the penis.
This includes ultrasonography which is used to identify the tear in the tunica albugenia. If USG is not able to pick up anything, then MRI is the preferred option.
It is a surgical and urological emergency. Surgery should be done to correct the deformity along with repair of the damaged blood vessels and nerves. The patient should be advised not to have sex for 4-5 weeks after surgery.
The complications of penile fracture are:
Damage to urethra
Pain during sexual intercourse
Jack GS, Garraway I, Reznichek R, Rajfer J. Current Treatment Options for Penile Fractures. Reviews in Urology. 2004;6(3):114-120.
A case of penile fracture with complete urethral disruption during sexual intercourse: a case report Klemen Jagodic, Marko Erklavec, Igor Bizjak, Sandi Poteko and Helena Korošec Jagodic.Journal of Medical Case Reports 2007, 1:14 doi:10.1186/1752-1947-1-14