Broken penis (in specialized literature - Penile fracture) is the traumatic rupture of the corpus cavernosum. It is an infrequent traumatism and requires an immediate medical attention. First case of broken penis is described in the literature back in 1925, in Iran. Some other less reliable sources, insist that the first case was described in the 11th century by Abu Casym, an Iranian doctor. Whatever the truth would be, by 2001 there are 1,331 cases of penile fractures described in the literature. That represents approx. 0, 63% of all urological pathology.

In the western hemisphere, there are 3 mail cases of broken penises: The absolute leader is the position woman on top: the penis slips and hits easer the perineum or the pubic symphysis. On the second place, there is the position “woman on the table”. In this case, the penis that slips out meets a hard desk margin. The table normally wins. On the third place for broken penises there is masturbation.

Another pretty frequent cause of penile fracture is alcohol. Well not directly, but there are cases in the literature that describe falling on erect penis, being drunk. But the top of the tops, absolutely exclusive cause is… hitting the opponent’s helmet during an American football game.

In the eastern hemisphere, most common cause of broken penis is it’s manipulation to achieve detumescence.

Additional rare etiologies include turning over in bed, a direct blow, forced bending, or hastily removing or applying clothing when the penis is erect.

The patient usually presents an acute pain in the penis, and a very clear history (well, in most cases) of having sex ether women on top or, having sex on the desk. Patients describe a popping, cracking, or snapping sound with immediate detumescence. They may report minimal to severe sharp pain, depending on the severity of injury.

On a physical examination there is a specific sign – the “eggplant deformity”. If you’ll take a look on the picture you’ll immediately understand why it is called so. The fractured penis is often quite tender to the touch. Because of the severity of pain, a comprehensive penile examination may not be possible.

Treatment of choice for penile fractures used to be a conservative one – cold compresses to resolve swollenness and pain, pressure dressings, painkillers and anti-inflammatory drugs, suprapubic urine deviation and fibrinolytics to preserve the function of the penis.

The high rate of complications leaded to a more active, surgical management of penile fracture. The operation consists in urethral defect suture (if present), and the management of tinica albuginea damage. Most authors report better results, more patient satisfaction and shorter hospitalization due to surgical approach to broken penises. Contraindications to surgical therapy include intolerance to general anesthesia and a history of penile trauma but completely normal physical examination findings.