A penis can sustain a severe injury often referred to as a “penile fracture,” even though it does not contain a bone. This condition is a serious medical emergency that requires immediate attention. It involves damage to the internal structures of the penis, which become engorged with blood during an erection.
Understanding Penile Fracture
A penile fracture is not a bone fracture, but rather a rupture of the tunica albuginea. This tough, fibrous sheath surrounds the corpora cavernosa, the two main erectile tissue columns running along the length of the penis. During an erection, these columns fill with blood, causing them to expand and the tunica albuginea to stretch and thin significantly. If the erect penis is subjected to sudden, forceful bending, this thinned tunica albuginea can tear, leading to a penile fracture.
Common Scenarios Leading to Injury
Penile fractures occur when the erect penis is subjected to blunt force or bending beyond its normal capacity. The most common cause is vigorous sexual activity. This often happens if the penis slips out of the vagina during intercourse and forcefully strikes against the partner’s pelvic bone or perineum, the area between the anus and genitals. Certain positions, such as “woman on top” or “doggy style,” are frequently associated with these injuries because the partner may not be able to stop movement quickly enough if the penis slips.
Other scenarios include rolling over forcefully onto an erect penis in bed or aggressive masturbation. In some cultures, a practice called “taqaandan” or “penile cracking,” which involves bending the erect penis to deflate it, can also lead to a fracture.
Identifying the Signs of Injury
Recognizing a penile fracture involves distinct and immediate signs. Individuals report hearing a sudden “popping,” “cracking,” or “snapping” sound at the moment of injury. This sound is followed by immediate severe pain and a rapid loss of erection. The penis will swell quickly and develop significant bruising, giving it a dark, discolored appearance often described as an “eggplant deformity.”
This discoloration occurs due to blood leaking from the torn tunica albuginea and pooling under the skin. Sometimes, the injury may also involve the urethra, the tube that carries urine, which can result in blood at the tip of the penis or difficulty urinating.
Urgent Medical Care and Treatment
Prompt diagnosis, usually through a physical examination, is often sufficient, though imaging studies like an ultrasound may be used to assess the extent of the injury. Surgical intervention is almost always required to repair the damage and prevent long-term complications.
During the surgery, the hematoma (blood clot) is evacuated, and the torn tunica albuginea is carefully stitched closed. Any other associated injuries, such as a tear in the urethra, are also repaired at this time. Early surgical repair, ideally within 24 hours of the injury, is associated with better outcomes and a lower incidence of complications.
Recovery and Long-Term Considerations
Following surgical repair, recovery typically involves a hospital stay of one to three days, with a catheter sometimes placed for 24 to 48 hours. Pain medication and antibiotics are usually prescribed to manage discomfort and prevent infection. Patients are generally advised to refrain from sexual activity for a minimum of four to eight weeks to allow for complete healing of the repaired tissues.
Despite successful surgical repair, some individuals may experience potential long-term complications. These can include erectile dysfunction (ED), where it is difficult to achieve or maintain an erection firm enough for sexual activity. Other possible issues are penile curvature, also known as Peyronie’s disease, which can result from scar tissue formation at the site of the tear, or painful erections. While surgery significantly reduces the risk of these complications, they can still occur in some cases.