Journal of Reconstructive Urology

.: ORIGINAL RESEARCH
When Should Surgery be Performed in Case of Penile Fracture to Prevent Erectile Dysfunction?
Penil Fraktüre Bağlı Erektil Disfonksiyonu Önlemek İçin Cerrahi Ne Zaman Yapılmalıdır?
Aykut BAŞERa, Yusuf ÖZLÜLERDENb, Okan ALKIŞc, Hülya YILMAZ BAŞERd, Ali Ersin ZÜMRÜTBAŞb
aHitit University Faculty of Medicine, Department of Urology, Çorum, TURKEY
bPamukkale University Faculty of Medicine, Department of Urology, Denizli, TURKEY
cKütahya Dumlupınar University Faculty of Medicine, Department of Urology, Kütahya, TURKEY
dDenizli State Hospital, Department of Emergency Medicine, Denizli, TURKEY
J Reconstr Urol. 2020;10(1):7-11
doi: 10.5336/urology.2019-72993
Article Language: EN
Full Text
ABSTRACT
Objective: To analyze the outcomes of the patients who underwent surgical treatment of penile fracture especially emphasizing the effects of the time of surgery on erectile function of the patients. Material and Methods: Between 2007 and 2019, 31 patients who were consulted with the complaints and suspicion of penile fracture to the Emergency Department of Pamukkale University Hospitals were evaluated retrospectively. Erectile functions both prior to the surgery and at postoperative 3rd month were evaluated. The patients who had an International Index of Erectile Function-5 (IIEF-5) decrease in the follow-up before the procedure and the patients who received medical treatment and no change in IEFF were divided into two groups. Compatibility of variables to normal distribution was evaluated with the Kolmogorov Smirnov test. The results were expressed in 95% confidence interval and p<0.05 was considered statistically significant. Results: In the study conducted on the etiology of a decrease in IEFF and the need for treatment after surgery, it was found that the rate of application to the emergency room within the first 6 hours statistically decreased the rate significantly. In addition, it has been found that the surgical application in the first 12 hours decreases both IEFF and the need for treatment in the IEFF. Conclusion: Penile fracture is a rare urological emergency. Erectile dysfunction which can be seen after penile fracture, is significantly reduced with early application of penile fracture within 6 hours to the hospital and surgical repair within the first 12 hours.

Keywords: Erectile dysfunction; emergency treatment; urologic surgical procedures, male
ÖZET
Amaç: Penil fraktür cerrahisi uygulanan hastaların özellikle cerrahi zamanının, tedavi sonrası erektil fonksiyonlar üzerindeki etkilerini vurgulayan sonuçları analiz etmek. Gereç ve Yöntemler: 2007 ve 2019 yılları arasında Pamukkale Üniversitesi Hastanesi Acil Servisi'ne penil fraktür şüphesi ile başvuran 31 hasta retrospektif olarak değerlendirildi. Ameliyat öncesi ve ameliyat sonrası 3. ayda erektil fonksiyonları değerlendirildi. Hastalar takiplerinde Uluslararası Erektil Fonksiyon İndeksi-5 (IIEF-5) skorlarında düşme olup bunun için tedavi alan ve IIEF-5 skor değişikliği olmayan 2 gruba ayrıldı. Değişkenlerin normal dağılıma uygunluğu Kolmogorov Smirnov testi ile değerlendirildi. Sonuçlar %95 güven aralığında ifade edildi ve p<0,05 istatistiksel olarak anlamlı kabul edildi. Bulgular: IEFF'de azalma etyolojisi ve tedavi ihtiyacı etyolojisi azatlmak için yapılan çalışmada, hastaların ilk 6 saat içinde acil servise başvurusu ile istatistiksel olarak anlamlı şekilde azaldığı bulundu. Ek olarak, ilk 12 saatte yapılan cerrahi uygulamanın hem IEFF'yi hem de IEFF'de tedavi ihtiyacını azalttığı bulunmuştur. Sonuç: Penil fraktür nadir görülen bir ürolojik acil durumdur. Penil fraktür tedavisi sonrası görülebilen sertleşme bozukluğu, hastaneye 6 saat içinde erken başvuruda bulunulması ve ilk 12 saat içinde de cerrahi onarım ile önemli ölçüde azalır.

Anahtar Kelimeler: Sertleşme bozukluğu ; acil tedavi ; ürolojik cerrahi işlemler, erkek
REFERENCES:
  1. Koifman L, Barros R, Júnior RA, Cavalcanti AG, Favorito LA. Penile fracture: diagnosis, treatment and outcomes of 150 patients. Urology. 2010;76(6):1488-92. [Crossref]  [PubMed] 
  2. Mirzazadeh M, Fallahkarkan M, Hosseini J. Penile fracture epidemiology, diagnosis and management in Iran: a narrative review. Transl Androl Urol. 2017;6(2):158-66. [Crossref]  [PubMed]  [PMC] 
  3. Hatzichristodoulou G, Dorstewitz A, Gschwend JE, Herkommer K, Zantl N. Surgical management of penile fracture and long-term outcome on erectile function and voiding. J Sex Med. 2013;10(5):1424-30. [Crossref]  [PubMed] 
  4. Ibrahiem HI, el-Tholoth HS, Mohsen T, Hekal IA, el-Assmy A. Penile fracture: long-term outcome of immediate surgical intervention. Urology. 2010;75(1):108-11. [Crossref]  [PubMed] 
  5. Reis LO, Cartapatti M, Marmiroli R, de Oliveira Júnior EJ, Saade RD, Fregonesi A. Mechanisms predisposing penile fracture and long-term outcomes on erectile and voiding functions. Adv Urol. 2014;2014:768158. [Crossref]  [PubMed]  [PMC] 
  6. Ateyah A, Mostafa T, Nasser TA, Shaeer O, Hadi AA, Al-Gabbar MA. Penile fracture: surgical repair and late effects on erectile function. J Sex Med. 2008;5(6):1496-502. [Crossref]  [PubMed] 
  7. el-Sherif AE, Dauleh M, Allowneh N, Vijayan P. Management of fracture of the penis in Qatar. Br J Urol. 1991;68(6):622-5. [Crossref]  [PubMed] 
  8. Amer T, Wilson R, Chlosta P, Albuheissi S, Qazi H, Fraser M, et al. Penile fracture: a meta-analysis. Urol Int. 2016;96(3):315-29. [Crossref]  [PubMed] 
  9. Aaronson DS, Shindel AW. U.S. National Statistics on Penile Fracture. J Sex Med. 2010;7(9):3226. [Crossref]  [PubMed] 
  10. Bozzini G, Albersen M, Otero JR, Margreiter M, Cruz EG, Mueller A, et al; European Association of Urology Young Academic Urologists. Delaying surgical treatment of penile fracture results in poor functional outcomes: results from a large retrospective multicenter European Study. Eur Urol Focus. 2018;4(1):106-10. [Crossref]  [PubMed] 
  11. Bolat MS, Özen M, Önem K, Açıkgöz A, Asci R. Effects of penile fracture and its surgical treatment on psychosocial and sexual function. Int J Impot Res. 2017;29(6):244-9. [Crossref]  [PubMed] 
  12. Pavan N, Tezzot G, Liguori G, Napoli R, Umari P, Rizzo M, et al. Penile fracture: retrospective analysis of our case history with long-term assessment of the erectile and sexological outcome. Arch Ital Urol Androl. 2014;86(4):359-70. [Crossref]  [PubMed] 
  13. Kati B, Akin Y, Demir M, Boran OF, Gumus K, Ciftci H. Penile fracture and investigation of early surgical repair effects on erectile dysfunction. Urologia. 2019;86(4):207-10. [Crossref]  [PubMed] 
  14. Barros R, Schul A, Ornellas P, Koifman L, Favorito LA. Impact of surgical treatment of penile fracture on sexual function. Urology. 2019;126:128-33. [Crossref]  [PubMed] 
  15. Falcone M, Garaffa G, Castiglione F, Ralph DJ. Current management of penile fracture: an up-to-date systematic review. Sex Med Rev. 2018;6(2):253-60. [Crossref]  [PubMed] 

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