By Dr Pius Musau

Fractures are mostly associated with bones. However, few people are aware of a urological emergency referred to as penile fracture. This is when an erect penis breaks in a manner similar to that of a bone.

Although the penis has no bone, its three cylindrical columns responsible for erection are tightly bound by tough covers, which in the event of forcible trauma, will crack, just like a bone.

The mechanisms of injury are usually embarrassing and men tend to take long before seeking medical attention, yet early intervention would help in a near normal recovery.

Causes of penile fracture

• A third of the cases occur during sex. A sudden turn in female dominant position is the leading cause as a result of the twisting. Others are penile slips that land on the pubis, between the legs or an office table in hasty trysts. A crazy dive into a woman will also have the same effect.

• Violent masturbation with exaggerated movements.

• Industrial accidents in which moving machines grab and twist trousers.

• A fall onto an erect penis

• Quick turn in bed

• Hasty dressing

• In the Middle Eastern countries, it may result from a forced control of erection.

How it happens

Penile fracture occurs only in an erect penis. The erection thins out the tough penile cover four to eight times and any sudden blunt trauma with motion on the penis will crack this cover and the underlying erectile cylinder.

There is a popping, cracking or snapping sound with immediate loss of erection and accompanying pain.

The penis swells and has an S-shaped deformity referred to as an eggplant deformity.

This is an emergency and should be dealt with in the soonest time possible. Many people however, get embarrassed and delay in seeking medical attention.

Treatment

Past attempts at non-surgical treatment of penile fracture using painkillers and external supports did not yield good results. Surgery repairs the torn penile cover and cylinder with restoration of the erectile capacity.

The writer is a lecturer at the Department of Surgery, Moi University, School of Medicine, Eldoret.