Pubic...Oops...Public Service Announcement: Fractured Penis

Exactly how does one go about fracturing a penis anyway? I will spare you the preliminary conversation we had at the office leading up to that question. Naturally, I had to look it up. The following is copied directly from WebMD:

Fractures to the penis, although uncommon, do occur. Discussing this in casual terms almost always causes men to cross their legs in response to the mere thought of this catastrophe. Even seasoned medical professionals cringe. Many physicians don't understand the underlying mechanism of this injury. Penile fracture can only occur with an erection. The vast majority of these injuries occur with sexual activity, although I have personally seen cases of a fractured penis that resulted when a man rolled on top of an erect penis while sleeping.

Penile fractures can also happen during masturbation. In one case, a teenager who was masturbating forced his erect penis into his jeans at the fear of discovery and fractured it. The vast majority of patients are so embarrassed they will often manufacture elaborate stories. In these scenarios, the old adage "truth is stranger than fiction" becomes significant. I have never seen a penile fracture in a man with a short penis. Fractures typically occur in men with longer-than-average penises, although I am certain it can happen in the whole spectrum of penis sizes.

The symptom complex is fairly classic. Typically the partner is on top, the penis becomes dislodged from the vagina and in an attempt to reinsert it, the partner will come down on the penis, striking the symphysis pubis, the female pelvic bone, just missing the vaginal opening, and creating a sudden bending. A loud snap and excruciating pain always follows, as well as the rapid development of a hematoma or bruise. Roughly 20 percent of the men will have an associated urethral injury as well. These injuries are not difficult to diagnose, and symptoms will depend upon the severity of the fracture.

Men with penile fractures are in excruciating pain and have a black-and-blue penis. When the diagnosis is equivocal--that is, there is a large bruise, but no obvious distortion or destruction--the penis is evaluated with corporal cavernosography. The urologist or radiologist places a fine needle into the corporal body of the penis and injects contrast material in order to examine the shape of the corporal bodies and to look for leakage. If there is a question of urethral injury, a retrograde urethrogram is also performed in which contrast material is instilled down the urethra via a small tube or catheter to look for leakage. Urethral injury is usually evident with blood in the urine at the time of the workup.

Surgery is the best treatment for fractures. The faster the torn tissues can be reapproximated, the better the healing process. The problem with conservative management is that fibrosis of the lining of the corporal body can create a bend and poor healing, as with a broken arm. Additionally, complications from expanding blood clots, such as a blood clot accumulation or a hematoma, or an infection of the hematoma can occur. These men with penile fractures are typically young, sexually active, and highly motivated to resume sexual activity as soon as the healing process is complete so surgery is often the best treatment.

There now. Aren't you glad you asked?