Yeah, yeah. Friday Weird Science is late. I know. Give Sci a break. She needed some sleep, and she is now full of delicious whole milk latte.
I have to begin this post with a direct quote from the paper, because no one can put it better:
“The human penis has always been the subject of much interest, especially, when afflicted with a medical condition”
Ain’t it so. Edit (I mentioned the wrong comma last time) Well, ok, I can ALMOST get behind this quote, except that I HATE that comma right after ‘especially’. It bugs me. A lot. But that’s the way it is.
But penises are interesting. If they weren’t, I wouldn’t write about them half so much. And when they get “broken”, they are even MORE interesting. And hard to fix.
Sawh, et al. “Fractured Penis: A Review” International Journal of Impotence Research (oh yes, there is one), 2008.
WARNING: The pictures behind the cut are not for the faint of heart. They are also probably NSFW, though they are so “surgical” in nature, I doubt the guy looking over your shoulder would really know what he was looking at. Except that it was cut open. You’ve been warned.
I’m sure you’ve all heard about people who’ve broken their penis, or been warned not to do something, for fear the penis will break, etc, etc. But what does this even MEAN? What does it mean when a penis breaks, and how does it repair? After all, humans are one of the only species that doesn’t have a baculum, or penis bone, so breaking something that doesn’t have a bone or cartilage seems like a pretty tall order.
But it can be done. Usually, a fractured penis is the result of “blunt trauma”. During sexual intercourse, this can happen when the penis is thrust forcefully at an opening, and…misses. Embarrassment plus breakage. Sounds like a great date night. It can also happen during masturbation, or, more rarely, when someone is trying to control or hide their erection, and forces it downward. And it can happen when a poor guy has the common “morning wood” and rolls over the wrong way in bed. I bet the thought of THAT will keep you up at night.
Fractured penis CAN occur in the flaccid penis, but it must be result of severe blunt trauma, and generally is present in only 3% of cases.
So what IS it to fracture your penis? To examine this, let’s go back to the classical anatomy of the penis that you’ve probably seen before if you’ve read Weird Science:
What you can see above is the erect penis (the business end is top left). The long pale space inside is the corpus cavernosa, now turgid and filled with blood. In the center of the penis (not visible in this picture) is the urethra. And the dark ridge surrounding the corcus canvernosa is the tunica albuginea.
The tunica albuginea is a fibrous, whitish tissue which basically is the covering of the corpus canvernosa, covering it and keeping it under pressure when it’s full of blood (so bloods not leaking all over everywhere, you know). This is the portion that generally breaks when someone gets a broken penis, and because it’s a tough layer, people usually report hearing a snapping or cracking sound.
Of course, that snapping noise is usually followed by some serious pain and swelling. For real. Like this:
So what you can see here is that you’ve got severe swelling (obviously that erection goes away right quick, unless you’ve also got priapism, in which case you’ve got a BIG set of problems), and a deviation of the penile shaft to the side opposite to the tear (in this case the tear is on the right side of the penis), as swelling forces the shaft to the other side.
A broken penis is pretty easy to diagnose (obviously, you want to let your doctor do this). The tear in the tunica can be felt using a “rolling sign”, where you can rolling the skin over a very specific area of swelling and tenderness. But, though it may be easy to diagnose, it’s not necessarily easy to fix. If the tear is really bad, it can also injure the urethra, which would present as blood in the urine and an inability to pass a catheter.
Now, if your urethra is torn, you obviously have to get some surgical correction. But if it’s just a normal broken penis, how do you go about repairing it? Well, there are various schools of thourhg. The most conservative is the one that basically says “ice it”. Usually they tell you to use compression bandages and ice, and a whole heck of a lot of tylenol. But this type of management is not recommended and usually not used anymore (meaning, if you get a fractures penis, do NOT treat it at home, see a doctor). This is because it’s associated with major complications, like the formation of fibrous plaques and scarring, and, well, impotence. The tear doesn’t usually “set” and heal like a bone, and complications occur in 53% of cases. Good enough reason to see the doctor.
So what’s the treatment now? Surgery. It ain’t pretty, but it’s better than a 53% chance of impotence, right? Unfortunately, this repair has a 25% complication rate. Not good, but better. Still, if possible, I’d refrain from breaking your penis. In the case of surgery, though small incisions can be used when you know exactly where the tear is, usually they have to ‘deglove’ the penis. The civilized way of saying “skin it”.
(I know I warned you about the pics. This one actually made SCI turn a little green, and it takes a LOT to turn me green.)
In this pic, the head of the penis is on the right (I think it’s the same penis as in the previous photo, but I’m not sure). The penis has been de-gloved, and the white mass you’re looking at is the tunica albuginea. The round deviation just left of center is the tear. What they end up doing here is suturing it shut (using dissolving stitches, obviously). This is actually not the complicated part of the surgery. The part that results in all the complications is the actual re-gloving of the penis, which results is a lot of swelling, especially if you’re cutting the skin off around the circumference of the penis. It’s believed that cutting near the scrotum, just enough to exposure the fracture site, might be a little better.
And this is the repaired site. I’ll admit I find this picture by FAR the most disturbing. Not because of the blood, but because DEAR GOD THEY AREN’T WEARING GLOVES!!!!1 Is that just me?!
So far, surgical repair seems to be the best course. But even so, it ain’t pretty. No sex for 6 weeks. In fact, NO ERECTIONS for six weeks. Usually the poor guys end up having to use sedatives. Your body is not always good to you. And the potential for a “suboptimal” erection is still there. So the conclusion: don’t break your penis. Just be careful where you stick that thing. It’s all fun and games until someone breaks a tunica.
Sawh, S., O’Leary, M., Ferreira, M., Berry, A., & Maharaj, D. (2008). Fractured penis: a review International Journal of Impotence Research, 20 (4), 366-369 DOI: 10.1038/ijir.2008.12