Vol. 7, Issue 2, Part A (2025)

Penile fracture is a rare but serious surgical emergency that tends to be underreported and treatment is often delayed due to patient embarrassment. To evaluate the effect on erectile function after immediate versus delayed repair for penile fracture. This quasi-experimental study was carried out at the Department of Urology, Dhaka Medical College Hospital (DMCH), Dhaka from January, 2023 to June, 2024. Thirty-six patients with penile fracture were enrolled in this study, of them eighteen were repaired immediately (Group A) and eighteen were repaired delayed (Group B). Patients with penile fracture aged within 16-65 years and preoperative International Index of Erectile Function-5 (IIEF-5) score ≥22 were included. IIEF-5 score was measured at 3 & 6 months postoperatively. Vascular cause of erectile dysfunction (ED) was also evaluated by duplex penile study at 6 months in all patients. Data were analyzed using SPSS 23. The mean age 36.72±12.69 year and 39.44±12.70 year in immediate and delayed repair group respectively (p>0.05). Vigorous sexual intercourse was the most common cause of penile fracture found in both Group A (61.1%) and in Group B (77.8%) and Masturbation (22.2% vs. 16.7%). In both groups A and B, 77.8% and 88.9% of the participants respectively, had a tear on the right side. Additionally, participants had a tear in the proximal part of corpus cavernosum in both Groups (61.1% and 77.8%), as well as in the mid part (27.8% and 16.7%). The average time between injury and surgery was 14.39±4.69 hours and 44.22±9.65 hours in Group A and Group B respectively. After 6 months, 16.7% in Group A and 38.9% in Group B developed ED. At the 3 months follow-up, the average IIEF-5 score was significantly lower in group B (19.67 ± 4.49) compared to Group A (22.11 ± 1.45). At the 6 months, the average IIEF-5 score was 22.06 ± 3.37 in Group A and 18.50 ± 5.12 in Group B that was statistically significant. All patients had normal penile duplex study at 6 months postoperatively. It was concluded that immediate repair of penile fracture causes less erectile dysfunction compared to delayed repair, meaning immediate repair retains a higher IIEF-5 score than delayed repair.