(510) Penile Fracture Repair: Long-Term Erectile Function, Urinary Symptoms, and Penile Deformity

Abstract Introduction Penile fracture (PF) is a urological emergency characterized by rupture of the tunica albuginea of the corpora cavernosa, occurring either in isolation or alongside a urethral tear. Early surgical intervention is crucial to restore normal function. However, long-term outcomes after PF repair-including erectile function, penile deformity, and plaque formation-remain poorly defined. Additionally, for patients with concurrent urethral injury, the risk of urethral stricture disease after successful repair remains uncertain. Objective This study aims to evaluate long-term urinary and sexual functional outcomes following PF, with or without urethral injury, using validated questionnaires. Methods All patients who have had a penile fracture repair done at a tertiary referral center were sent out a questionnaire including the International Index of Erectile Function- Erectile Function Domain (IIEF-EFD 6 questions 1-5 max 30) as well as the International Prostate Symptoms Score (IPSS) encompassing 7 questions assessing voiding and storage urinary symptoms. 0 - 7 = mildly symptomatic; 8 - 19 = moderately symptomatic; 20 - 35 = severely symptomatic. There were additional questions related to Results A total of 108 men responded. The mean age at PF was 41 (12) years. Imaging to diagnose PF was utilized in 96% of patients with predominantly ultrasounds in 95 and MRI in 18 cases. 50% had a ventral longitudinal incision, 43% penoscrotal incision and 6% degloving incision. Overall, 20% cases had bilateral corporal injury whilst remaining 80% had unilateral corporal fracture. A urethral injury was identified and repaired in 29 (27%) of cases using 4-0 vicryl or 4-0 monocryl. Corporal tunical fracture was repaired with 0/0 PDS in 85% of cases and 2/0 PDS in the remainder. The mean IIEF-6 and IPSS scores for all patients were 25.3 (6.5) and 2.9 (4.6), respectively. There was no statistically significant difference in IIEF-6 scores between patients with urethral injury (25.8 6.3) and those without urethral injury (24.8 7.6, p=0.49). Similarly, IPSS scores were comparable between the urethral injury group (2.3 3.5) and the non-urethral injury group (3.2 4.9, p=0.29). PDE5i usage was reported in 17 patients overall (15.7%), with no significant difference between groups (p=0.07). Penile curvature was reported in 34 patients (31.5%), of whom the majority described minimal curvature. One patient is currently awaiting corrective surgery for penile curvature. No patients required urethral surgery during follow-up. Conclusions Timely surgical repair of penile fracture, including cases with urethral injury, preserves erectile function and does not increase the risk of urethral stricture disease. Around one-third of patients report some degree of penile curvature following repair, though most cases are mild. Disclosure No