Penile Injuries

Penis is the most important male genital organ that serves several important functions such as urination, copulation and reproduction. Any injury, damage or trauma to the penis can significant compromise the normal quality of life and may aggravate the risk of complications in the long term.

Common Penile Injuries

Penile injuries are fairly common; despite the rather concealed and protected anatomical location of penis. Most common cause of penile injury is trauma (direct or indirect) to the inguinal region. It is imperative to mention that every case of penile injury should be managed with extreme caution and care; due to a likely risk of injury to the urethra. Most common types of penile injuries are briefly discussed as under:

Cuts: The most common pattern of penile injury is cut or abrasion. Most cases are due to accidental entrapment of penile skin in the zipper of pants, while pulling up the zip. The injury is really painful, but the cut is usually minor and heals quickly without any residual abnormality. During recovery period, the individual should avoid sexual intercourse and take prophylactic antibiotics to prevent infection; especially if the cut is deep.

According to a new study reported in the peer reviewed British Journal of Urology International (2), investigators suggested that one-fifth of all penile injuries are zip related. Between 2002 and 2010, more than 17 616 cases of zip-related injuries were reported in the emergency departments of US hospitals.

Bruises: Bruising over the penis or scrotum is usually a result of trauma from a blunt force, such as kick or knee impact during a fight or contact sports. It is ideally recommended to apply icepacks or cold compresses to reduce pain and swelling. If the pain is severe, and does not resolve after an hour of injury or worsen with swelling over the testes, it is ideally recommended to see a healthcare professional as early as possible.

Fractures: Penile fracture refers to a break in the continuity of corpus cavernosum – the tube like structure that transmits blood to maintain the erection during sexual intercourse. More than one-third cases of penile fracture are a result of vigorous sexual activity (usually reported when woman is on the top). Penile fracture presents with pain, painful erection, incontinence of urination, swelling and reddish purple discoloration of penis (evidence of underlying bleeding) etc. Penile fracture is a medical emergency and immediate attention is needed to minimize the risk of permanent deformity. So far, only 1331 cases of penile fracture are reported in medical literature (as of 2001); but it is believed that actual figures are much higher.

Chafing: A significant rubbing force or friction between penile skin and a rough surface can lead to chafing injury. Such as masturbation without any lubricant, wearing tight pants etc. Chafing injuries usually resolve spontaneously with rest and relaxation. Seek medical help if symptoms doesn’t resolve spontaneously.

Penetrating Penile Injuries: Most penetrating injuries involving inguinal region are gunshot wounds. According to latest statistics, more than 35% of all gunshot injuries involve inguinal region. In addition, isolated penile injuries are reported in 25% cases.

Penile amputation: Most cases of penile amputation are self-inflicted (as an attempt to self-mutilation) during a psychotic event or during a gender transformation surgery or management of penile cancer.

According to a study reported in the Open Journal of Urology (3), investigators suggested that the most common complications of poorly managed penile injuries are:

• Painful penile erections (36.5% cases)
• Erectile dysfunction (9.4% cases)

Looking after yourself

• Cover the cut or bruises with a clean, dry dressing such as a cotton handkerchief temporarily; before getting professional medical help.
• A good alternative to dry dressing is to cover the area with a clean sticking film.

• Avoid home remedies, creams or lotions on your penile wound without consulting a healthcare professional.
• If bleeding occurs, press your fingers against the bleeder for at least ten minutes or until the bleeding stops.
• Never cloak anything such as bandage or tape around your penis and scrotum.
• Never attempt to get rid of a foreign body from a penile wound/ inguinal region. Always seek medical assistance to minimize the risk of complications.
• Immediately unwrap, if something is tightly wrapped around the penis.
• Always protect the area damaged as much as you can, before going to the hospital and to a doctor to prevent further damage or injury to the penis.
• Ask the physician for pain reliving medication if any, in case you are under significant pain.
• Apply the icepack to resolve penile swelling; but make sure to never apply the ice directly on the penile skin. Always use a clean towel to avoid direct contact of ice with the underlying penile skin.

References

1. Mehta, S. D., Krieger, J. N., Agot, K., Moses, S., Ndinya-Achola, J. O., Parker, C., & Bailey, R. C. (2010). Circumcision and reduced risk of self-reported penile coital injuries: results from a randomized controlled trial in Kisumu, Kenya. The Journal of urology, 184(1), 203-209.

2. Bagga, H. S., Tasian, G. E., McGeady, J., Blaschko, S. D., McCulloch, C. E., McAninch, J. W., & Breyer, B. N. (2013). Zip‐related genital injury. BJU international, 112(2), E191-E194.

3. Zango, B., Kabore, F. A., Pare, A. K., Kirakoya, B., Yameogo, C. A. M. K. D., Ouattara, A., & Zare, C. (2015). Trauma to the Male External Genitalia: Epidemiology, Diagnosis and Therapeutic Aspects at Yalgado Ouedraogo Teaching Hospital of Ouagadougou. Open Journal of Urology, 5(07), 103.