Sexual function outcomes and risk factors of erectile dysfunction after surgical repair of penile fracture

Erectile dysfunction affects millions of men worldwide. Twin studies support the role of genetic risk factors underlying erectile dysfunction, but no specific genetic variants have been identified. We conducted a large-scale genome-wide association study of erectile dysfunction in 36,649 men in the multiethnic Kaiser Permanente Northern California Genetic Epidemiology Research in Adult Health and Aging cohort. We also undertook replication analyses in 222,358 men from the UK Biobank. In the discovery cohort, we identified a single locus (rs17185536-T) on chromosome 6 near the single-minded family basic helix-loop-helix transcription factor 1 (SIM1) gene that was significantly associated with the risk of erectile dysfunction (odds ratio = 1.26, P = 3.4 × 10−25). The association replicated in the UK Biobank sample (odds ratio = 1.25, P = 6.8 × 10−14), and the effect is independent of known erectile dysfunction risk factors, including body mass index (BMI). The risk locus resides on the same topologically associating domain as SIM1 and interacts with the SIM1 promoter, and the rs17185536-T risk allele showed differential enhancer activity. SIM1 is part of the leptin–melanocortin system, which has an established role in body weight homeostasis and sexual function. Because the variants associated with erectile dysfunction are not associated with differences in BMI, our findings suggest a mechanism that is specific to sexual function.

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Penile fracture and investigation of early surgical repair effects on erectile dysfunction

Urologia Journal ◽

10.1177/0391560319844657 ◽

2019 ◽

Vol 86 (4) ◽

pp. 207-210

Author(s):

Bulent Kati ◽

Yigit Akin ◽

Mehmet Demir ◽

Omer Faruk Boran ◽

Kemal Gumus ◽

...

Keyword(s):

Erectile Dysfunction ◽

Erectile Function ◽

Surgical Repair ◽

Urethral Injury ◽

Penile Curvature ◽

Penile Fracture ◽

Direct Trauma ◽

Significant Difference ◽

The Mean ◽

Erect Penis

Objectives: Penile fracture is one of the urological emergencies caused by direct trauma to an erect penis during sexual intercourse, which results in a tear in the tunica albuginea within the corpus cavernosum. Serious complications such as penile curvature and erectile dysfunction may develop due to inappropriate and/or late surgical repair. This study aims to evaluate patients with penile fracture and to describe their demographics, surgical repairs, and long-term outcomes. Materials and Methods: A total of 56 patients who were diagnosed with penile fracture between January 2012 and June 2017 were reviewed. Clinical features, pre-operative assessment, time from injury to surgery, tunica defect properties, and presence of urethral injury were assessed. Early surgical management was performed. Outcomes, including International Index of Erectile Function 5 pre-operation and after 6 months, were evaluated. Results: The mean age was 30.2 (18–57) years. In etiological questionnaires, 32 (57.2%) patients reported direct trauma to an erect penis during intercourse. The mean size of tunica defects was 1.61 ± 0.42 (0.3–3.6) cm of the nine (16%) patients, and penile fracture was associated with urethral injury. There was no significant difference in International Index of Erectile Function 5 scores before the surgery and 6 months after surgery. Penile skin necrosis developed in one patient 10 days post-operation. Conclusion: Early surgical repair could be an effective method of achieving post-operative erection success in patients with penile fracture due to direct trauma during intercourse.

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Penile Fracture with Associated Urethral Rupture

Case Reports in Medicine ◽

10.1155/2010/791948 ◽

2010 ◽

Vol 2010 ◽

pp. 1-3 ◽

Cited By ~ 6

Author(s):

Nicholas A. Boncher ◽

Gino J. Vricella ◽

Jason T. Jankowski ◽

Lee E. Ponsky ◽

Edward E. Cherullo

Keyword(s):

Erectile Dysfunction ◽

Surgical Repair ◽

Potential Outcomes ◽

Urethral Injury ◽

Penile Curvature ◽

Penile Fracture ◽

Injury Treatment ◽

Key Aspects ◽

Urethral Rupture ◽

Erect Penis

Penile fracture of the erect penis is an uncommon but emergent urological trauma. Potential outcomes include erectile dysfunction, penile curvature, and urethral injury. Treatment is emergent surgical repair. We present the case of a 42-year-old man with a penile fracture complicated by a urethral rupture and subsequent repair. A discussion of the key aspects of this condition is presented.

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Sexual function, satisfaction, and association of erectile dysfunction with cardiovascular disease and risk factors in cardiovascular high-risk patients: Substudy of the ONgoing Telmisartan Alone and in Combination with Ramipril Global Endpoint Trial/Telmisartan Randomized AssessmeNT Study in ACE-INtolerant Subjects with Cardiovascular Disease (ONTARGET/TRANSCEND)

American Heart Journal ◽

10.1016/j.ahj.2007.03.024 ◽

2007 ◽

Vol 154 (1) ◽

pp. 94-101 ◽

Cited By ~ 41

Author(s):

Michael Böhm ◽

Magnus Baumhäkel ◽

Jeffrey L. Probstfield ◽

Roland Schmieder ◽

Salim Yusuf ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Erectile Dysfunction ◽

High Risk ◽

Sexual Function ◽

High Risk Patients ◽

Assessment Study ◽

Risk Patients

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OUTCOMES OF SURGICAL MANAGEMENT OF FRACTURE PENIS: EXPERIENCE FROM A TERTIARY CARE HOSPITAL IN BANGLADESH

Public Health of Indonesia ◽

10.36685/phi.v5i4.313 ◽

2019 ◽

Vol 5 (4) ◽

pp. 122-130

Author(s):

Md. Selim Morshed ◽

AKM Musa Bhuyian ◽

Mohammad Saruar Alam ◽

Md. Towhid Belal ◽

Sayem Hossain ◽

...

Keyword(s):

Erectile Dysfunction ◽

Erectile Function ◽

Surgical Repair ◽

Tunica Albuginea ◽

Tertiary Care ◽

Self Report ◽

Care Hospital ◽

Penile Fracture ◽

Uncommon Presentation

Background: Penile fracture is an emergency and uncommon presentation to the urology department. Immediate surgical repair can be a standard of care for patients with penile fracture. Objective: The study was conducted to evaluate the outcome of surgical repair of the fractured penis.Methods: This quasi-experimental study was conducted from Jan 2017 to Dec 2018 in the urology department of Dhaka Medical College Hospital, Bangladesh. Thirty-five patients with fractures of the penis were included in this study. After proper evaluation, surgery was performed under spinal anesthesia. Follow up was scheduled at 6th week, 3rd month, and 6th month. We used validated questionnaires of the ‘International index of erectile function (IIEF-5)’ for married and ‘Single question self-report (SQSR)’ for unmarried patients to evaluate postoperative erectile function.Results: Total 35 patients completed three follow up. The mean age of patients was 36.4 years, and 88% of them were married. The most common triggers were for vigorous sexual intercourse (68.5%) followed by history of rolling over in bed with erect penis (20.0%). Per-operative findings were: rupture of tunica albuginea (100%); rupture of corpora cavernosa on the right (65.7%). After 6th month, 28 patients (80%) were able to maintain their normal erectile function. However, seven patients developed erectile dysfunction, of which 4 had a mild form, and 3 had mild to moderate form erectile dysfunction. All patients complained of pain during or after intercourse, but the pain has gradually subsided with time.Conclusion: Immediate surgical exploration and repair of fracture penis can offer complete recovery of sexual and voiding functions.

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