The objective of the study was to highlight the epidemiology, aetiology, presentation, diagnosis and outcomes of penile fracture in China.
Except reporting eight cases, we also retrieved literatures from Chinese publications between January 1984 and July 2017. Data extracted included authors, regions and year of publication, aetiology, clinical features, diagnosis, treatment and outcome.
In 113 publications 984 cases (including our eight cases) were retrieved. An annual incidence in China has been estimated between 0.002/million and 0.2/million male populations. The commonest causes were coitus and masturbation. Clinical features were the classical triad of "cracking" sound, immediate detumescence and pain. Swelling, ecchymosis and deformity were present in the majority of patients. Diagnosis was made mainly on clinical grounds; ultrasonography can be very helpful in equivocal cases. Concomitant urethral injury accounted for 6.3% of all cases. Treatment options were surgery and conservative in 92.2% and 7.8% patients, respectively. Early surgical repair was advocated because a higher incidence of complications was found in conservatively treated patients. Complications of the injury included penile curvature, nodules, infection, painful coitus, urethral fistula, and erectile dysfunction.
Penile fracture may be underreporting which can usually be diagnosed based solely on history and physical examination findings. Early surgical repair is obviously preferable option because of excellent results even in the presence of urethral injury.