Penis Shape Disorders
Penile curvature can be defined as the deviation of an erection penis in one direction. Sometimes may be caused by a decrease in the compliance of albugenia on the tunica on one face and sometimes by the shortening of the erectile structure on one face. Penile curves can be congenital or acquired. Terminologically, ” chordee ” can be used as curvature. Acquired curvatures may be due to fractures after a trauma (often during coitus) or to Peyronie’s disease. Acquired curvatures can be dorsal, lateral, ventral or complex like nonsciences.
The absolute indication for surgical treatment in penile curvature cases is the prevention of coitus due to deviation. The most commonly used methods are the Nesbit technique, the plication technique, and rarely the penile prosthesis implantation.
The most accepted method in penile curvature correction is the Nesbit technique. The technique described in 1965 includes the plication of disproportionately prolonged dorsal tunica albuginea.
The sudden bending of the erect penis can be defined as the detumescence of the tunica albugine and the draining of the blood in the corpus cavernosum from the rupture site. Penile fracture occurs as a result of blunt trauma to the penis. Generally it is caused by when the penis gets out of vagina and penetrates the pubis or perineum. Other reasons; Twist of penis during masturbation, unconscious nocturnal manipulation as it rotates on the bed. Physical examination revealed edema and ecchymosis in the penis.
Treatment of penile fracture is controversial. Because in the initial reports nonoperative approach is recommended, the new literature supports early surgical repair. Nonoperative management is preferred in patients with concomitant urethral injury. This approach typically consists of printing on penis, ice packs and analgesics.
Surgical repair of penile fracture involves the evacuation of the hematoma, debridement and repair of the injured tunica albugine.
At the same time, urethral injury should be determined during surgery. If the urethral injury is a complete incision, it requires a proper repair on a catheter. Partial urethral injury can only be treated with a urethral catheter insertion, suprapubic cystostomy placement or primary repair. The urethral catheter in these samples may remain while the patient is discharged one day later and may be withdrawn after 1-2 weeks.
As a result, penile fracture is uncommon with its characteristic findings. In case of suspected penile fracture, urgent diagnostic evacuation and surgical repair is necessary to minimize the potential complications.