음경골절의 임상상과 치료: 한국에서의 다기관 연구 결과

Backgrounds: Penile fracture is the traumatic injury of the tunica albuginea of the corpus carvernosum in erectile state. This study was designed to evaluate clinical manifestations, diagnostic and therapeutic modalities. Methods: Between December 1992 and July 2003, 72 patients were evaluated after penile injury. History taking and physical examination were performed in each patient and if needed, radiologic examination and operation was undergone. Results: The mean age of patients was 42 years old (18-72 years old), and causes of penile fracture were sexual intercourse (44 cases: 61.1%), masturbation (8 cases: 20.8%), and fingerpressure (4 cases: 5.6%) in order. As a preoperative radiologic examination, penile sonography was performed in 30 cases and carvernosogram in 20 cases. In each group, 4 and 3 cases who showed no sign of penile fracture underwent an operation, and it revealed carvernosal rupture in 1 case in both groups. Among 57 patients (79.1%) who had an early operation, 52 patients were found to have rupture of corpus carvernosum. The most common site of penile fracture was proximal shaft (28 cases: 53.9%) and then midshaft (15 cases: 28.9%) and distal shaft (5 cases:9.6%). Injury involved unilateral and bilateral corporeal rupture in 49 cases (Rt.:35, Lt.:14) and 3 cases. The overall complication rate in patients who had an early operation was 8.9% (4 of 45 cases) in compare to 66.7% (8 of 12 cases) in patients who did not. Conclusions: Our experience demonstrates that the most common cause and site of penile injury are sexual intercourse and right proximal shaft respectively, and an early operation would be an effective treatment to prevent complications. When penile fracture is not clinically definite, radiologic examination, such as carvernosogram or penile sonography, can be helpful in making diagnostic and therapeutic plan.