Long term complications of penile fracture repair: Erectile dysfunction and penile curvature

Objective: To determine the factors that cause erectile dysfunction and penile curvature after repair of penile fracture (PF). Methods: Data from 25 patients who underwent PF repair was retrospectively analyzed. PF was diagnosed by examining patients' medical histories and performing physical examinations. All patients underwent immediate PF repair. All patients filled out the International Index of Erectile Function (IIEF-5) form and penile curvature was examined. Results: The median age of patients at the time of surgery and the median follow-up duration were 46 years (22-60 years) and 95 months (12-156 months), respectively. Two of the patients had concomitant urethral injury. At the final follow up, erectile dysfunction (ED) was present in 13 patients (52%). Among these patients, 9 patients (36%) had mild ED and 4 patients (16%) had moderate ED. With a univariate analysis, age and penile curvature were significantly associated with ED (p= 0.008 and p = 0.039, respectively). With a multivariate analysis, age was independently associated with ED (p= 0.048, odds ratio= 1.104, 95% confidence interval 1.000-1.218). The IIEF-5 scores correlated with age (p= 0.009, r= 0.510). Seven patients (28%) had penile curvature and one patient underwent penile ptication surgery. Conclusion: After PF repair, age is the only risk factor for ED and penile curvature rarely requires surgical treatment. (C) 2022 Asociacion Espanola de Andrologia, Medicina Sexual y Reproductiva. Published by Elsevier Espana, S.L.U. All rights reserved.