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FRACTURE OF THE PENIS IN THE NIGER DELTA REGION OF NIGERIA.

BACKGROUND
Penile fracture is a surgical emergency which often frightens the patient and partner. Varying incident rates, precipitating mechanisms and outcomes of treatment have been reported from different parts of the world.


AIM
To determine clinical presentation, aetiological factors and outcome of treatment of penile fracture in Port Harcourt, Niger Delta region of Nigeria.


METHODS
This was a retrospective study of all patients who presented with penile fracture to our institution from 2007 and 2015. Data on age of patient, events leading to the injury, mode and time of presentation, mode and outcome and complications of treatment were collected and analysed with SPSS 20.0 software.


RESULTS
Twenty one patients with a median age of 34.0 years (21-45) were treated within the study period. Nine patients (42.9%) were married. Overenthusiastic/ vigorous sex-related events were responsible for penile fracture in 17 patients (81.0%). Seven injuries were self inflicted while in 14 patients (66.7%), partners were involved. All the patients presented with pain, swelling, sudden detumescence and deviation of the penis. The right side was affected in 61.9% of the cases. The penile mid-shaft was the site of injury in 57.1% of cases. Six patients (28.6%) had associated urethral injuries. Eighteen patients (85.7%) had immediate surgery, 2 patients (9.5%) refused surgery and were treated conservatively. One patient who presented late was also managed conservatively. All but one patient had satisfactory penile erections with no significant complications.


CONCLUSION
Overenthusiastic and vigorous sexual activities were the most common causes of penile fracture in this study. A third of the patients had associated urethral injuries. Early surgical repair led to satisfactory outcome.