Penile Fracture: It can really happen

Written By Dr. Jason Goldman

As an internist, I have been asked all sorts of questions ranging the spectrum of the human condition. One of my male patients was concerned about a condition he heard of and wanted to know if it was real. The question was if the penis can be broken. The quick answer is that it certainly can. Fortunately, this is a rare condition but it does occur and is certainly a medical emergency that needs to be dealt with immediately to avoid complications, further damage and injury.

Before discussing the injury, it is important to understand the basic anatomy of the penis. The male organ is essentially comprised of two large tubes known as the corpus cavernosum with a smaller tube known as the urethra. The two corpus cavernosum are surrounded by a covering called the tunica albuginea. The urethra is the opening that urine flows from and connects from the outside of the body to the bladder. The corpus cavernosum fill with blood and cause an erection. The tissue is able to stretch but it has a limit to how much before injury can occur.

When the penis is erect, the corpus cavernosum are under increased pressure to maintain the erection. Any significant trauma can cause the tunica albuginea to break and the blood will leak out into the surrounding tissue. This is known as a penile fracture. It is quite painful and needs immediate attention. The fracture can lead to symptoms of severe pain, swelling, bruising or black and blue discoloration, blood with urination if the urethra is damaged and abnormal curvature of the penis. If a penile fracture occurs it would require surgical intervention by an urologist to correct the damaged tissue and prevent complications. It can usually be diagnosed with a physical exam but may require an ultrasound or MRI to fully determine the location of the injury. This is a medical emergency and any male who experiences this injury should immediately go to the emergency room. If not treated, the fracture can lead to scar tissue which can cause impotence, abnormal curvature, urinary issues and disfigurement.

Understanding the anatomy of the penis, symptoms of fracture and treatment leads to the next issue of how it can occur and how to prevent it. While this injury is uncommon, certain positions are more likely to cause this injury. The most common position is woman on top as this usually results in all her body weight on top of the male and if the woman is in the wrong position on the penis then it could lead to an abnormal bending and possible fracture. It can occur with other positions if the male does not properly insert and attempts to penetrate in the wrong place. Essentially, any time the penis is bent in the wrong direction and too much pressure is put on the shaft, it could lead to a fracture. Even masturbation could lead to this condition if done too aggressively. The more forceful, aggressive or violent the penetration, the greater the risk of fracture.

While this is a rare and uncommon condition, it does occur and requires immediate medical attention. Care must be taken to avoid a penile fracture and the symptoms need to be recognized. With more awareness of the issue and prompt response, long term complications can be prevented and normal function can be restored.