In An Unusual Case, Man Broke His Penis During Sex

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Penile Fracture
One of the signs of a penile fracture is the so-called "eggplant" sign (Photo by: ... [+] UNIVERSAL IMAGES GROUP VIA GETTY IMAGES
  • A penile fracture is a urological emergency that requires operative intervention within the first 24 hours.
  • Classic features of penile fracture include: “popping sound”, “immediate detumescence” and palpable “rolling sign”.
  • This article describes the first documented case of a vertical penile fracture with no “popping sound”.

A penis splitting vertically from top to bottom is an extremely rare occurrence. Up until this case, there were no documented cases of vertical penile fractures, making this case a first of its kind. As reported, the 40-year-old man presented to the emergency with a complaint of his penis being “buckled against his partner’s perineum”. Doctors suspected that the patient was suffering from a penile fracture, however, according to the patient there was “popping” sensation with visibly moderate swelling.

Further examination did not show any palpable “rolling” sign. To rule out a ruptured dorsal vessel or suspensory ligament, the doctors advised a penile MRI. Findings of the MRI showed a vertical disruption of the tunica albuginea, (fibrous tissue that covers the testis), along the medial third of the penile shaft. A penile fracture is defined as a tear of the tunica albuginea when an erect penis is subjected to an abnormal bending force. This results in an acute increase in the intracavernosal pressures which exceeds the tensile stress of the tunica albuginea, resulting in tear or fracture.

Penile fracture is a more common occurrence during sexual intercourse

The injury is more commonly seen in men in their 40s, as in this case. Classic signs of penile fracture include a popping sensation with immediate detumescence following blunt trauma. Examination is consistent with a grossly swollen ecchymotic (also known as the egg-plant sign) and “rolling” sign. In 71% of the cases, the penis bends to the left because of a fracture in the right corpora, sponge-like regions of erectile tissue.

Similarly, the surgeons were able to confirm the presence of a 3 cm vertical tear guided by the MRI. However, there is no photographic evidence of the case because of COVID-19 photography restrictions. As per standard protocol the patient was quickly operated with an uneventful recovery. Six months after recovery, there were no significant signs of changes to the penis. He was able to have sex again with the same quality of erection as prior to the injury.

According to the case study, 88.5% of penile fractures occur during sexual intercourse with ‘doggy style’ and ‘man on top’ being the two main positions causing the fracture. Other reported causes include masturbation, sleeping prone and ‘taqaandan’, a practice in Middle Eastern countries.

References

Atypical presentation of a vertical penile fracture https://casereports.bmj.com/content/14/6/e243353

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Dr. Aiman Shahab is a dentist with a bachelor’s degree from Dow University of Health Sciences. She is an experienced freelance writer with a demonstrated history of working in the health industry. Skilled in general dentistry, she is currently working as an associate dentist at a private dental clinic in Karachi, freelance content writer and as a part time science instructor with Little Medical School. She has also been an ambassador for PDC in the past from the year 2016 – 2018, and her responsibilities included acting as a representative and volunteer for PDC with an intention to make the dental community of Pakistan more connected and to work for benefiting the underprivileged. When she’s not working, you’ll either find her reading or aimlessly walking around for the sake of exploring. Her future plans include getting a master’s degree in maxillofacial and oral surgery, settled in a metropolitan city of North America.

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