Penile Fracture

What is a penile fracture?

A penile fracture isn’t really a fracture because the penis isn’t really a bone. However, you can “break” your penis if you severely bend or hit it while you have an erection.

Your penis contains tubelike erectile tissues: two that run the length of the top of your penis (corpora cavernosa) and one that runs along the bottom of your penis (corpus spongiosum), which also surrounds the urethra. A strong, fibrous connective tissue layer (tunica albuginea) covers these tissues. A penile fracture occurs when the tunica albuginea tears open.

How serious is a penile fracture?

Penile fracture is an emergency. You must get medical help immediately.

How common is penile fracture?

It’s unclear how often penile fracture occurs. Some reports say it may occur in 1 in 10,000 to 1 in 100,000 people who have a penis. However, it may be more common but rarely reported because many who experience a penile fracture don’t recognize that it’s a medical emergency and avoid seeking treatment.

What are the symptoms of penile fracture?

Penile fracture symptoms often include:

• A popping or cracking sound.
• Immediate loss of erection.
• Bruising and swelling from the buildup of blood under your skin.
• Blood in your urine (hematuria) or at the tip of your penis.
• Pain while peeing (dysuria).

What does a penile fracture feel like?

A penile fracture usually causes immediate and intense pain. The pain may go away shortly, or it may last for a long time.

Can a penile fracture go unnoticed?

In most cases, if you fracture your penis, you’ll hear a popping or cracking sound, immediately lose your erection and feel intense pain along with swelling and bruising. You’ll usually also have difficulty getting any more erections. If it isn’t a penile fracture, you might have another type of soft tissue injury.

What causes penile fracture?

Blunt force to your erect penis causes penile fracture. Common causes include:

• Sexual intercourse with a partner. This often occurs when your penis slips out of your partner, and you try to thrust it in again — but instead, you hit or bend your penis against their pelvic bone or perineum (the layer of skin between their anus and genitals).
• Energetic masturbation. Energetic or rough masturbation can forcefully bend your erection.
• Unintentional trauma. This is much less common depending on the amount of force to your erect penis. But it may include falling onto your erection, rolling over onto it or hitting it against a wall or door in a dark room.
• Taqaandan. This is a method of bending your erect penis in order to change its shape or to discourage masturbation by making an erection go away. Taqaandan is more common in the Middle East or Central Asia.

Who does penile fracture affect?

Penile fractures are more likely to occur in people 40 and under who are more sexually active.

How is penile fracture diagnosed?

A healthcare provider may be able to diagnose a penile fracture by physical examination alone. But they may also order tests to confirm their diagnosis, including:

• Ultrasound.
• Magnetic resonance imaging (MRI).
• Retrograde urethrogram (RUG).

How is penile fracture treated?

If a healthcare provider diagnoses a penile fracture in time, a urologist will repair your penile fracture with surgery. The urologist will repair the tunica albuginea with stitches (sutures). They’ll also look for and repair other injuries that may occur during penile fracture, such as a tear in the urethra. Successful penile fracture surgery should improve your chances of normal erections in the future and allow you to comfortably pee and ejaculate.

Can penile fracture be cured without surgery?

A true penile fracture requires surgery to reduce your odds of having erection difficulties in the future. You may get permanent erectile dysfunction if you don’t have surgery to fix the fracture.

If you injure your penis tissues but don’t have a fracture, then you should have nonoperative treatment. Nonoperative treatment may include:

• Ice packs.
• Foley catheterization.
• Nonsteroidal anti-inflammatory drugs (NSAIDS) or acetaminophen (Tylenol®).

What happens if a penile fracture goes untreated?

It’s not a good idea to try to let your penis heal a fracture by itself. Without treatment, a penile fracture may make it difficult or impossible for you to get or keep an erection long enough for sexual intercourse. You may also experience penile curvature. And you’re also at a higher risk of developing other problems, such as:

• Difficulty peeing.
• Scar tissue formation.

What are the possible complications of surgery to repair penile fracture?

Possible complications of penile fracture repair surgery include:

• Penile curvature.
• Weak tissue inside the penis, which can form an opening (fistula).
• Painful erections.

It’s also possible that you could get erectile dysfunction even if a healthcare provider repairs your penile fracture.

How soon after treatment will I feel better?

Most people can go home after penile fracture surgery. After you go home, you’ll need follow-up visits to check that your penis is healing properly and that you aren’t having any problems peeing.

When can I have sex after a penile fracture?

Your surgeon will give you an idea of when you can expect to engage in sexual activity again after penile fracture surgery. But in general, you should refrain from all sexual activity, including sexual intercourse and masturbation, for at least a month after surgery. You should also pay attention to your erections to check if there’s improvement over time.

Can penile fracture be prevented?

You can avoid penile fracture by not bending your erect penis on purpose.

As you get older, your erections may get softer. It can also be more challenging to maintain firmness during sexual intercourse. You’re at a greater risk of bending a softer erection unexpectedly during sexual intercourse. It’s a good idea to talk to a healthcare provider as soon as you notice your erections getting softer. They can prescribe medications that help increase blood flow to your penis, such as:

• Sildenafil (Viagra®).
• Vardenafil (Levitra®).
• Tadalafil (Cialis®).
• Avanafil (Stendra®).

It’s also a good idea to take precautions while having sexual intercourse:

• Guide your penis if you change positions or if your penis slips out.
• Use lubricants (lube) to help reduce friction.
• Be careful in positions where you can’t make eye contact with your partner, such as if your partner is on top or if you’re behind your partner.

What can I expect if I have a penile fracture?

With prompt treatment, the outlook for penile fracture is good. The success rate for penile fracture surgery is over 90%.

When should I see a healthcare provider?

Go to the nearest emergency room if you injure your erect penis and have penile fracture symptoms.

If you injure your erect penis and don’t get immediate care, you should still talk to a healthcare provider, especially if you have:

• Difficulty getting erections.
• Problems peeing.
• Blood in your pee.
• Discoloration (red, purple, black or blue), swelling or pain in your penis.
• Any other symptoms that bother you.

After penile fracture surgery, contact a provider if you have excessive pain, bleeding or signs of infection, including:

• Chills.
• Fever.
• Headache.

What questions should I ask a healthcare provider?

You may want to ask your provider:

• How do you know that I fractured my penis?
• Do you think I should have surgery?
• How often should I schedule follow-up appointments?
• Should I see a urologist?

What is the difference between penile fracture and avulsion penile trauma?

Avulsion penile trauma is when skin on your penis gets pulled or ripped off. Avulsion penile trauma often happens during industrial accidents. It isn’t the same type of injury as a penile fracture. With a penile fracture, the skin is usually intact.

A note from Cleveland Clinic

The idea of seeking treatment for an injury to your penis can be embarrassing for many, especially if the injury occurred during sexual activity. You may think your symptoms will go away if you rest or put ice on your penis. But any time you have severe pain, it’s your body’s way of telling you that something is wrong and you need help, even if it’s in a sensitive area. Get medical attention as quickly as possible to reduce your risk of long-term complications.