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Is penile fracture as bad as it sounds? Yes. This injury is rare, thankfully, and it can be avoided by taking particular care with sexual positioning.
Among the more cringe-worthy mishaps known to befall man, probably few are as dreaded as penile fracture. But wait, you say, how can a body part that has no bone get a fracture? Trust us, it happens, and it’s every bit as painful as it sounds.
While it’s true that the penis has no bones, clever expressions to the contrary notwithstanding, it can experience serious damage while erect. Such damage occurs when the erect penis is so violently bent that the fibrous outer lining of one or both of the penis’s two chambers of spongy erectile tissue actually ruptures. Those chambers are known as the corpora cavernosum.
Tell-Tale Signs of Injury
Apart from a sickening snapping or popping sound at the moment of fracture, this sort of injury has a handful of other tell-tale signs. You will almost certainly lose your erection within seconds after the injury, and within minutes your penis will show signs of dark bruising, as the blood held within the corpus cavernosum with the ruptured lining floods into the other tissues of your penis.
And, lest we forget, pain, lots and lots of pain, which makes it especially important for those aware of such an unpleasant eventuality to take all possible steps to prevent becoming a victim. As we noted earlier, this rare sort of injury occurs when an erect penis is violently bent. According to an article at MensHealth.com, a Brazilian study found that half of all penile fractures occurred during sexual intercourse when the female partner was on top.
Woman-on-Top Position Perilous
Authors of the Brazilian study, which was published in a 2014 issue of “Advances in Urology,” offer one hypothesis as to why this position is particularly fraught with danger for the male partner. When a woman is in the upper position, sexually, she controls “the movement with her entire body weight landing on the erect penis, not being able to interrupt it when the penis suffers a wrong way penetration, because the harm is usually minor in [a] woman with no pain but major in the penis. On the contrary, when the man is controlling the movement, he has better chances of stopping the penetration energy in response to the pain related to the penis harm, minimizing it.”
While the woman-on-top position accounted for at least half of the penile fractures among heterosexual males in the Brazilian study, the next highest number of fractures occurred during doggy-style couplings. The study’s authors note that vaginal intercourse is the primary cause of most penile fractures among men in Western society.
However, this sort of damage is often self-inflicted among men in the Middle East, particularly Iran, where the prevailing culture pressures men to hide their erections. This is sometimes accomplished by manually bending the erect penis to achieve a flaccid state.
Urethra Sometimes Damaged as Well
As previously noted, in cases of extreme trauma to the penis, the outer linings of both corpora cavernosum may rupture. In such cases, it is not uncommon for the penile urethra to also rupture, exacerbating the injury to the penis significantly. The urethra carries urine from the bladder and semen from the testicles.
The Brazilian study, conducted by researchers at the University of Campinas, looked at 44 cases of suspected penile fracture, confirming that 42 actually fit the criteria established for their research. The mean age of patients in the study was 34.5 years old. Twenty-eight of the cases, accounting for two-thirds of all the penile fractures studied, occurred during heterosexual intercourse; six occurred during penile manipulation; and four occurred during homosexual intercourse. Six patients reported that the cause of their penile fractures was unclear. Six patients sustained an injury to their urethras during the course of the penile fracture incident.
Surgery Usually Required
In a Medscape.com overview of treatment options for penile trauma, including penile fracture, Detroit urologist Richard A. Santucci, M.D., says that such traumatic injuries should be considered urologic emergencies, most of which require surgical intervention. Penile fracture, he notes, can usually be diagnosed based solely on the patient’s history and physical examination. In equivocal cases, however, Dr. Santucci says that MRI or diagnostic cavernosography may have to be performed.
While penile fracture was often treated very conservatively in the past, the high rate of complications after such injuries has caused a major shift in thinking among urologists. In the past, such conservative therapy has included cold compresses, pressure dressings, penile splinting, and the use of fibrinolytic medications to break down blood clots that may have formed.
Possible Complications
Among the complications experienced in the wake of conservative treatment of penile fracture have been penile abscess, nodule formation at the site of the injury, overlooked urethral injury, permanent penile curvature, painful erection, painful intercourse, and erectile dysfunction. Dr. Santucci said the primary goals of surgical repair “are to expedite the relief of painful symptoms, to prevent erectile dysfunction, to allow normal voiding, and to minimize potential complications due to delay in diagnosis.” The current consensus within the urologic community, the doctor says, is to opt for immediate surgical repair, and thus reducing the rate of complications, length of hospital stays, while increasing the level of patient satisfaction.
Should you be among the unlucky few who experience penile fracture, your best bet is to head directly to the emergency room of the nearest hospital. While it is an injury that can be a bit embarrassing, failure to seek immediate care can have serious consequences. In an interview with MensHealth.com, Jacob Rajfer, M.D., professor of urology at UCLA’s David Geffen School of Medicine, says this injury usually requires surgery to repair tears in penile tissue.
Seek Care Immediately
Dr. Rajfer cautions against the tendency of some penile fracture victims to put off that trip to the hospital. Failure to undergo surgery within three days of the injury significantly increases the rate of complications. “It becomes much more difficult to repair it, and scarring can start to form,” he says.
Robert J. Hartman Jr., M.D., Brigham and Women’s Hospital in Boston, recounted a case of penile fracture in the March 12, 2015, issue of the “New England Journal of Medicine.” Accompanying the account was a photograph of the penile injury sustained by a 42-year-old man who inadvertently jammed his erect penis into the perineum of his lover during intercourse. According to the article, the man “heard a snap, noticed a rush of blood from the meatus [urethral opening at the tip of penis], had immediate detumescence [loss of erection], and had severe pain.”
Patient Treated Promptly
According to Dr. Hartman’s account, “On the basis of the clinical presentation, the patient was taken to the operating room for emergency repair.” Postoperative recuperation was uneventful, and the patient was discharged from the hospital the morning after surgery. The patient, seen both three months and six months after surgery, “regained erectile function without appreciable plaque formation or penile curvature.”
If you’d like to read additional articles about male sexuality and related topics, check out our blog. And if you’re interested in convenient ordering of erectile dysfunction drugs like Viagra, we invite you to visit eDrugstore.com.
Don Amerman is a freelance author who writes extensively about a wide array of nutrition and health-related topics.
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