Management of Penile Fractures in Bujumbura: Epidemiological, Diagnostic, Therapeutic and Functional Outcome Aspects

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Background: Penile fracture is a rare non-infectious emergency of the lower urinary tract and genital organs. Aim: To analyze the epidemiological, diagnostic, therapeutic, and outcomes aspects of penile fracture in the uro-andrology departments of the Kamenge University Hospital Center and KIRA Hospital at Bujumbura. Patients and Methods: This prospective descriptive study analyzed four cases of penile fracture managed at Kamenge University Hospital and KIRA Hospital (Burundi) over a one-year period (April 1, 2022, to March 31, 2023). Results: During the period of our study, 4 patients were operated for penile fracture. The average age was 33.4 years. Penile fractures accounted for 2.16% of uro-andrological emergencies (n = 4). Three patients (75%) were married while the other (25%) was single. Sexual intercourse with coital misstep was the leading cause (75%). All patients presented with pain, swelling, and a cracking sound; urethrorrhagia was noted in one case. Surgical exploration confirmed tunica albuginea rupture in all cases, with one patient having an associated urethral injury. All patients underwent surgical repair. Three patients (75%) had undergone albuginorraphy and a cavernorraphy associated with albuginorraphy was performed in one patient (25%). A Foley catheter was inserted. At 3-month follow-up, three patients had normal erectile function (IIEF-5: 22 - 25), while one had mild dysfunction (IIEF-5: 20). Conclusion: Penile fracture is a rare but serious urological emergency. Early diagnosis and immediate surgical management of penile fractures yield favorable outcomes with low complication rates. A high index of suspicion and prompt intervention are key to preserving sexual function and avoiding long-term sequelae.