Penile vascular abnormalities observed long-term after surgical repair of penile fractures

Aim: To assess the penile vascular system in men long-term after surgical treatment of penile fractures. Patients and Methods: During a 15-year period, 36 cases of penile fracture underwent immediate surgical repair at the University of Istanbul, Turkey. At least 1 year after operation, all patients were invited for penile vascular evaluation. 15 patients accepted our call and were enrolled in our study. They were evaluated with detailed medical and sexual history, a serial of serum analyses, and penile color Doppler ultrasonography. Results: By history, 6 of the 36 (16.6%) patients who had undergone surgical repair had erectile dysfunction (ED). The mean interval between surgical intervention for penile fracture and penile vascular evaluation was 3.6 ± 1.9 (range 1.5-8) years. Evaluation of the penile vascular system of 15 men (mean age 35.7 ± 17.3, range 21-63 years) revealed normal vascular system in seven (46.7%), while cavernosal insufficiency was observed in four (26.7%) and arterial insufficiency in three (20%) men. The remaining case (6.7%) was diagnosed to have mixed arterial and cavernous insufficiency. Erectile dysfunction in two cases was considered to be in psychogenic origin and vascular in the remaining four. Conclusion: Although immediate repair is reported to be the treatment of choice in penile fractures, ED of either a physiological or vascular origin can be encountered as a long-term sequel and deserves to be evaluated in detail.