Penile Fractures: Symptoms, Diagnosis, and When to Seek Help - Urology

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Penile fractures, although rare, can occur during vigorous sexual activity, particularly when there is a sudden force applied to an erect penis. This can happen if the penis slips out of the vagina and strikes a hard surface or if there is a sudden bending motion. Understanding the symptoms and when to seek medical help is crucial for proper management.


Symptoms of Penile Fracture
1. Audible Sound: Many patients report hearing a "popping" or "cracking" sound at the time of injury.

2. Immediate Pain: Severe pain typically follows the injury, which may be localized to the shaft of the penis.

3. Swelling and Bruising: There may be swelling and bruising around the area, although this may not always be present immediately.

4. Deformity: A noticeable bend or deformity in the penis may occur, which is often described as a "banana" shape.

5. Difficulty with Erection: While some men may still achieve an erection, it may be painful or unstable, and the penis may exhibit unusual movement, as described in your case.


Diagnosis
Diagnosis of a penile fracture is primarily clinical, based on the history of the injury and the physical examination. In some cases, imaging studies such as ultrasound or MRI may be used to confirm the diagnosis and assess the extent of the injury. However, if a fracture is suspected, especially with significant deformity or pain, surgical intervention is often recommended.


When to Seek Help
Given the symptoms you described, particularly the unusual movement of the penis during erection, it is advisable to seek medical attention promptly. While the absence of severe pain, swelling, or difficulty urinating is a positive sign, the fact that the penis can move 360 degrees during an erection is concerning. This could indicate a potential injury to the tunica albuginea, the fibrous sheath surrounding the erectile tissue, which could lead to complications if not treated.


Recommended Actions
1. Immediate Evaluation: It is important for your boyfriend to see a healthcare provider as soon as possible. A urologist would be the most appropriate specialist to evaluate the situation.

2. Avoid Sexual Activity: Until a proper evaluation is conducted, it is advisable to refrain from any sexual activity to prevent further injury.

3. Monitoring Symptoms: While waiting for an appointment, monitor for any changes in symptoms, such as increased pain, swelling, or changes in urination or erectile function.


Conclusion
In summary, while your boyfriend may not exhibit all the classic signs of a penile fracture, the unusual movement during erection is a red flag that warrants further investigation. It is better to err on the side of caution and seek medical advice sooner rather than later to ensure that any potential injury is properly assessed and treated. Early intervention can help prevent complications such as erectile dysfunction or penile curvature in the future.