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Increase in fracture of the penis in south-west Nigeria.

Tijani KH, Ogo CN, Ojewola RW, Akanmu NO - Arab J Urol (2012)

Bottom Line: Eighteen patients had surgical treatment, with a satisfactory outcome.The rapid demographic changes in south-west Nigeria are probably responsible.Surgical repair, irrespective of the delay before intervention, usually offers a satisfactory outcome.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Section of Urology, Lagos University Teaching Hospital, Lagos, Nigeria.

ABSTRACT

Objective: To present our recent experience in the management of penile fracture.

Patients and methods: We present 21 cases of penile fracture managed at the two Federal-owned tertiary hospitals in two neighbouring states in south-west Nigeria between 2001 and 2011. The diagnosis was based mainly on a clinical evaluation. The treatment was surgical in patients who presented within 2 weeks of the fracture. The emphasis during the follow-up was on erectile function and micturition.

Results: Seventeen patients presented within 48 h, two presented after a week, while two reported months later with penile deviation. The mean age of the patients was 26.4 years. The cause of fracture was sexual intercourse in 11 (52%) patients and forceful manipulation of the erect penis in 10 (48%). Thirteen (62%) of all injuries occurred in the last 2 years of the study, of which eight men were injured during rear entry with the woman on top (reverse coital) position. Six of the patients with reverse coital injuries reported trying the position after watching it on the Internet, specifically on their cellular phones. Eighteen patients had surgical treatment, with a satisfactory outcome. Two of the other three patients had penile deviation during erection.

Conclusions: The incidence and causes of penile fracture appear to have changed drastically over the last 2 years in our environment. The rapid demographic changes in south-west Nigeria are probably responsible. There appears to be a relationship between the cause of fracture and the use of the Internet, although that might be coincidental. Surgical repair, irrespective of the delay before intervention, usually offers a satisfactory outcome.

No MeSH data available.


Related in: MedlinePlus

The phallus of the patient with a PF during oral sex.
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f0015: The phallus of the patient with a PF during oral sex.

Mentions: In the present review of cases seen over an 11-year period, only eight (38%) were seen within the first 9 years, while the remaining 13 (62%) were seen over the last 2 years, with 2011 accounting for nine (43%) of all cases. From a mean of 0.8 cases per year during last decade there was a four-fold increase in 2010 and an 11-fold increase in 2011. Overall, although forceful digital manipulation and sexual intercourse accounted for a similar number of cases, there was a striking difference in the pattern of distribution. Between 2000 and 2009, forceful digital manipulation of the erect penis was responsible for seven of eight cases, while in 2010–2011 sexual intercourse was responsible for 10 of 13 cases. All cases of PF during manipulation were self-inflicted except in two patients. In one the fracture occurred during a disagreement with his partner during oral sex, with the injury said to be caused by a combination of the partner’s mouth and hands. The main findings consisted of a distal tear in the tunica albuginea and some unclear skin indentations (Fig. 3). The second case occurred in a patient with stuttering priapism while being assisted by the partner to achieve detumescence. However, in eight of the 10 cases of PF from sexual intercourse, between 2010 and 2011, the injury occurred during coitus in the RC position. This is consistent with reports that describe an increased risk with the RC position [3]. Does this indicate a change in sexual practice among Nigerian couples? This is almost impossible to prove in an environment where the open discussion of sex is still a taboo. At present we can only speculate. The rapidly changing demography of south-west Nigeria could be the key factor underlying this increase in cases of PF. With a population growth rate 10 times faster than New York and Los Angeles (arising mainly from immigration), the United Nations estimates that Lagos will become the third largest city in the world (after Bombay and Tokyo) by 2015 [11]. The rapid increase in population and the increase in the cosmopolitan nature of the society are more likely to increase the number of sexual encounters, increase more liberal attitudes toward sex, and the reporting of sex-related medical problems.


Increase in fracture of the penis in south-west Nigeria.

Tijani KH, Ogo CN, Ojewola RW, Akanmu NO - Arab J Urol (2012)

The phallus of the patient with a PF during oral sex.
© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4442948&req=5

f0015: The phallus of the patient with a PF during oral sex.
Mentions: In the present review of cases seen over an 11-year period, only eight (38%) were seen within the first 9 years, while the remaining 13 (62%) were seen over the last 2 years, with 2011 accounting for nine (43%) of all cases. From a mean of 0.8 cases per year during last decade there was a four-fold increase in 2010 and an 11-fold increase in 2011. Overall, although forceful digital manipulation and sexual intercourse accounted for a similar number of cases, there was a striking difference in the pattern of distribution. Between 2000 and 2009, forceful digital manipulation of the erect penis was responsible for seven of eight cases, while in 2010–2011 sexual intercourse was responsible for 10 of 13 cases. All cases of PF during manipulation were self-inflicted except in two patients. In one the fracture occurred during a disagreement with his partner during oral sex, with the injury said to be caused by a combination of the partner’s mouth and hands. The main findings consisted of a distal tear in the tunica albuginea and some unclear skin indentations (Fig. 3). The second case occurred in a patient with stuttering priapism while being assisted by the partner to achieve detumescence. However, in eight of the 10 cases of PF from sexual intercourse, between 2010 and 2011, the injury occurred during coitus in the RC position. This is consistent with reports that describe an increased risk with the RC position [3]. Does this indicate a change in sexual practice among Nigerian couples? This is almost impossible to prove in an environment where the open discussion of sex is still a taboo. At present we can only speculate. The rapidly changing demography of south-west Nigeria could be the key factor underlying this increase in cases of PF. With a population growth rate 10 times faster than New York and Los Angeles (arising mainly from immigration), the United Nations estimates that Lagos will become the third largest city in the world (after Bombay and Tokyo) by 2015 [11]. The rapid increase in population and the increase in the cosmopolitan nature of the society are more likely to increase the number of sexual encounters, increase more liberal attitudes toward sex, and the reporting of sex-related medical problems.

Bottom Line: Eighteen patients had surgical treatment, with a satisfactory outcome.The rapid demographic changes in south-west Nigeria are probably responsible.Surgical repair, irrespective of the delay before intervention, usually offers a satisfactory outcome.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Section of Urology, Lagos University Teaching Hospital, Lagos, Nigeria.

ABSTRACT

Objective: To present our recent experience in the management of penile fracture.

Patients and methods: We present 21 cases of penile fracture managed at the two Federal-owned tertiary hospitals in two neighbouring states in south-west Nigeria between 2001 and 2011. The diagnosis was based mainly on a clinical evaluation. The treatment was surgical in patients who presented within 2 weeks of the fracture. The emphasis during the follow-up was on erectile function and micturition.

Results: Seventeen patients presented within 48 h, two presented after a week, while two reported months later with penile deviation. The mean age of the patients was 26.4 years. The cause of fracture was sexual intercourse in 11 (52%) patients and forceful manipulation of the erect penis in 10 (48%). Thirteen (62%) of all injuries occurred in the last 2 years of the study, of which eight men were injured during rear entry with the woman on top (reverse coital) position. Six of the patients with reverse coital injuries reported trying the position after watching it on the Internet, specifically on their cellular phones. Eighteen patients had surgical treatment, with a satisfactory outcome. Two of the other three patients had penile deviation during erection.

Conclusions: The incidence and causes of penile fracture appear to have changed drastically over the last 2 years in our environment. The rapid demographic changes in south-west Nigeria are probably responsible. There appears to be a relationship between the cause of fracture and the use of the Internet, although that might be coincidental. Surgical repair, irrespective of the delay before intervention, usually offers a satisfactory outcome.

No MeSH data available.


Related in: MedlinePlus