Management of penile fracture: Can it wait?

To assess the effect of timing of presentation of cases with penile fracture on the long-term outcome of surgical intervention. Between 2000 and 2015, 42 patients with penile fracture were operated in our centre, immediately after admission. To assess the effect of timing of presentation, patients were classified into 2 groups: group 1 with early presentation (≤24 h) and group 2 with delayed presentation (>24 h). All patients had a routine follow-up visit at 6 months after surgery; during this visit, long-term complications were assessed. Group 1 included 26 patients (62%) and group 2 included 16 (38%). In group 1, patients presented to the emergency department from within 24 h (mean: 3.96 ± 2.47 h) after occurrence of the penile trauma. Patients in group 2 presented from 24 h to 4 days (mean: 79.50 ± 37.62 h). The incidence rate of long-term complications was 7.6% and 68.7% in group 1 and group 2, respectively (OR 26.4, 95% CI 4.41–157.86, p = 0.0001). Concerning erectile dysfunction and penile nodules, there was no significant difference between the two groups (p = 0.67 and 0.06, respectively). However, painful penetration was significantly higher in group 2 (50% vs 3.8% in group 2 and 1, respectively, OR 25, 95% CI 2.69–231.59, p = 0.001). Penile curvature was seen only in the second group (43.8%). Immediate surgical repair has the best prognosis and should remain the recommended treatment modality of penile fracture.