Abstract Introduction Penile fracture is an uncommon urological emergency involving a tear of the tunica albuginea that occurs during an erection. Although early surgical intervention is typically performed, patients may continue to experience complications related to erectile function, sexual health, and psychosocial well-being Objective This study was conducted to evaluate postoperative erectile function, sexual health, and psychosocial outcomes in patients undergoing surgical repair for penile fracture Methods This ampispective observational study included all patients diagnosed with penile fractures who underwent surgical repair between January 2023 and March 2025. Demographic characteristics, injury etiology, clinical findings, and lesion features were retrospectively recorded from the patient’s medical records. Follow-up was conducted via telephone. Postoperative evaluations included both pre- and postoperative scores from the International Index of Erectile Function-5 (IIEF-5). Erectile rigidity was assessed using the Erection Hardness Score (EHS). The SEAR questionnaire was employed to assess the psychosocial impact, examining sexual relationships and psychological elements relevant to men experiencing erectile dysfunction. Results A total of 82 patients were included in the analysis. The mean age at the time of injury was 37.2 ± 8.9 years. The majority (62.2%) of the injuries were caused by vigorous sexual intercourse. Four patients (4.9%) had concomitant urethral injury. Most patients (91.5%, 75/82) were hospitalized within 24 hours. A significant proportion (92.7%) of patients had unilateral cavernous injury, while only 6 patients (7.3%) experienced bilateral cavernous injury. The median tear length measured 15 mm (IQR: 10–20). The most common late postoperative complications included palpable penile nodules (14.6%, 12/82). 65 patients (79.3%) achieved an Erection Hardness Score (EHS) of 4 following sexual stimulation, while 17 patients (20.7%) reported a score of 3, with no cases of EHS below 3 observed. The postoperative incidence of erectile dysfunction (ED) was 15.9% (13/82), with all cases classified as mild to moderate in severity. Univariable and multivariable analyses identified bilateral corporal rupture as an independent predictor of postoperative erectile dysfunction (OR = 3.27; 95% CI: 1.21–8.82). Urethral injury was significant in univariable analysis (OR = 3.95; 95% CI: 1.21–12.84) but lost significance after adjustment, while age, presentation delay, lesion location, and tunical tear length showed no associations. Psychological outcomes assessed by the SEAR questionnaire demonstrated a significant decline in sexual relationships, confidence, and self-esteem among patients undergoing surgery within the first year (p 0.05), with subsequent improvement observed in the second year Conclusions Surgical intervention for penile fracture leads to favorable long-term functional and psychosocial results. In our cohort, the occurrence of postoperative erectile dysfunction was low and mainly mild. Bilateral corporal rupture was identified as a key predictor of compromised erectile function. Psychosocial domains, such as sexual relationships, confidence, and self-esteem, declined in the first year after surgery but recovered by the second year. These findings highlight the importance of prompt surgical repair and encourage further prospective studies to validate prognostic factors. Disclosure No
Vinh et al. (Mon,) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: