(875) Penile Fracture: Impact of Surgical Technique on Early Functional Outcomes (IIEF-5, IPSS) — Tertiary-Care Cohort

Introduction Penile fracture is a urological emergency in which expedited repair mitigates structural and functional sequelae. Western series report sexual intercourse as the main etiology and urethral rupture in 10–25%. Guidelines endorse immediate exploration with targeted urethral assessment when clinically suspected. Comparative data linking corporal repair strategy to length of stay (LOS), time to catheter removal, and early function are limited. Objective To compare LOS and time to catheter removal across corporal repair techniques and assess early functional change by IIEF-5 and IPSS. Methods Retrospective cohort (2021–2025) of 33 surgically explored patients at a tertiary center. Approaches: degloving with corpororrhaphy; degloving with circumcision; midline incision with corpororrhaphy; perineal exploration with corpororrhaphy. Primary outcomes: LOS and time to catheter removal (days). In 25 patients with pre-event and follow-up questionnaires, early function was ΔIIEF-5 = post − pre (negative = worsening) and ΔIPSS = post − pre (positive = worsening); minimal clinically important difference (MCID): IIEF-5 decline ≥4 and IPSS increase ≥3. Two-tailed Kruskal–Wallis and Mann–Whitney tests were used. When available, we recorded corporal location, tear orientation, longitudinal position, and laterality. Exploratory analyses assessed prior circumcision and concomitant circumcision (within degloving procedures) for associations with LOS, catheter days, and complications (Mann–Whitney; Fisher’s exact). Results More extensive approaches-degloving (with or without circumcision) and perineal exploration-were associated with longer LOS (global difference, p = 0.012). Median LOS was 3.5 days with extensive approaches compared with 2.0 days with midline incision (absolute difference ≈1.5 days). Time to catheter removal was also longer with extensive approaches (trend, p = 0.065): median 9.5 days compared with ≈1–1.5 days (absolute difference ≈8 days). This pattern reflected greater lesion complexity treated with extensive approaches, including cases with urethral rupture; one case used a perineal approach. Among 25 patients with pre- and post-operative questionnaires, ΔIIEF-5 was similar across techniques (p = 0.318), and ΔIPSS showed small global variation (p = 0.050). Clinically relevant worsening (MCID) occurred in 28% for IIEF-5 and 8% for IPSS, without meaningful differences between techniques. Exploratory analyses showed no material impact of prior circumcision or concomitant circumcision on LOS, catheter days, or complications. Conclusions Choosing more extensive approaches when anatomy requires it increased immediate care use (LOS and catheterization), with clearly quantified absolute differences-≈1.5 additional LOS days (3.5 compared with 2.0) and ≈8 additional catheter days (9.5 compared with ≈1–1.5)-but no early functional penalty on IIEF-5/IPSS. MCID-level deterioration rates (28% for IIEF-5; 8% for IPSS) did not differ by technique, suggesting that injury complexity, rather than the technique itself, explains higher immediate resource use. Sensitivity checks-removing the perineal case and analyzing patients with and without urethral rupture separately-left conclusions unchanged. Overall, the data support an anatomy-guided surgical strategy capable of managing complex injuries while preserving early functional outcomes. Disclosure No