What to do if the corpus cavernosum of the glans penis is damaged

The corpus cavernosum is the main component of the penis. Damage to the corpus cavernosum of the glans penis is usually caused by external forces, such as too strong sexual movements or too long erection. The importance of the glans penis is self-evident. If there is a problem with this part, the first thing that will be affected is the sex life, and the patient is also worried about the impact on fertility. So, what should we do if the corpus cavernosum of the glans penis is damaged? Let's take a look at the solution below.

Generally speaking, any part of the penis may fracture, but the most common fracture is in the proximal 1/3 of the penis. The incidence rate is similar on the left and right sides, with transverse fractures being more common and ruptures on both sides at the same time being rare. The corpus cavernosum of the urethra is less congested during penis erection and has a lower hardness than the corpus cavernosum of the penis, so the probability of rupture is low.

The vast majority of patients have a typical history of injury during penile erection, and the patient or his sexual partner can usually hear a "crackling" sound. After the injury, the penis will experience severe local pain, and the penis will quickly become soft, followed by swelling and bruising. The penis will bend and deform, and may swell to the opposite side, in an "S" shape, or droop downward. If the penile fascia is intact, the hematoma is limited to the penis. If the penile fascia is ruptured, the penile hematoma will spread to the scrotum and perineum. Penile "fracture" will cause difficulty in urination due to the hematoma pressing on the urethra, but it generally does not damage the urethra. If accompanied by urethral injury, hematuria or bleeding from the urethral opening will occur. Local palpation can feel a firm, swollen, isolated mass at the penile fracture site, over which the penile skin can slide back and forth.

1.Surgery

In recent years, early surgical treatment is advocated. Surgery can be performed under local anesthesia, spinal anesthesia or epidural anesthesia.

(1) Surgical treatment without urethral injury: A local incision, a circular incision, or a penoscrotal incision is performed. After finding the ruptured site, the hematoma is completely removed and the ruptured tunica albuginea is sutured with absorbable sutures. For recurrent cases, the tunica albuginea needs to be sutured with non-absorbable sutures. A pressure bandage is routinely applied after the operation.

(2) Surgical treatment of combined urethral injury: choose penile circular incision, remove blood swelling, explore the penile corpus cavernosum and urethral corpus cavernosum, find the broken and damaged parts, and repair the ruptured tunica albuginea and urethral corpus cavernosum. Place a urinary catheter. Apply pressure bandage to the penis for 2-3 days. Preventive use of antibiotics, estrogen, sedatives, etc. after surgery.

Conservative treatment is suitable for patients with small tunica albuginea fissures and no penis curvature. The main measures include local cold compress, pressure bandage, hemostasis, anti-inflammatory, thrombolysis, anti-androgen erection prevention, etc., and antibiotics can be used preventively. However, after conservative treatment, hematoma organization is easy to form induration, which may affect future erectile function.

Prognosis

As long as penile fracture is treated in time, the prognosis is generally good, but the following complications may occur later: such as erectile dysfunction (ED), penile curvature deformity, painful penile erection, sexual intercourse pain, pseudodiverticulum, penile artery aneurysm, high-flow ectopic penile erection, lymphedema, urethral stenosis, penile arteriovenous fistula, corpus cavernosum-urethral fistula, penile nodules and recurrence.