Erectile function after penile fracture: clinical and predictive insights

Función eréctil tras la fractura de pene: perspectivas clínicas y predictivas

Background: This study aimed to identify the clinical and demographic factors associated with postoperative erectile dysfunction in patients undergoing early surgical repair for penile fracture. Methods: This retrospective study included patients who underwent surgical treatment for penile fracture between January 2015 and January 2025 at two tertiary care centers. Patients with confirmed tunical rupture during surgery and known preoperative erectile status were included. Erectile function was assessed using the 5-item International Index of Erectile Function (IIEF-5) at baseline and at 6 months postoperatively. Patients with a ≥4-point decrease in IIEF-5 score at month 6 were defined as having developed erectile dysfunction (ED). Associations between clinical/demographic variables and ED development were analyzed statistically. Results: A total of 64 patients were included in the study. The mean age of the patients was 43.0 ± 12.2 years. Early surgical exploration was performed in all cases. At 6 months, 21.9% of patients had significant postoperative ED. Univariate analysis revealed that age was the only variable significantly associated with ED (p = 0.0076). Receiver Operating Characteristic (ROC) analysis identified ≥50 years as the optimal age cut-off for predicting ED (Area Under the Curve (AUC): 0.727; sensitivity: 57.1%; specificity: 82.0%). No other clinical variables were found to be significantly associated with postoperative ED. Conclusions: Despite early surgical intervention, a considerable proportion of patients developed ED following penile fracture. Age was the only variable significantly associated with long-term erectile function in our analysis. These findings emphasize the importance of age in both preoperative counseling and postoperative follow-up planning.

Resumen

Antecedentes: Este estudio tuvo como objetivo identificar los factores clínicos y demográficos asociados con la disfunción eréctil postoperatoria en pacientes sometidos a reparación quirúrgica temprana por fractura de pene. Métodos: Este estudio retrospectivo incluyó a pacientes sometidos a tratamiento quirúrgico por fractura de pene entre enero de 2015 y enero de 2025 en dos centros de atención terciaria. Se incluyeron pacientes con ruptura túnica confirmada durante la cirugía y con estado eréctil preoperatorio conocido. La función eréctil se evaluó mediante el Índice Internacional de Función Eréctil de 5 ítems (IIEF-5) al inicio y a los 6 meses del postoperatorio. Los pacientes con una disminución de ≥4 puntos en la puntuación IIEF-5 al mes 6 fueron definidos como portadores de disfunción eréctil desarrollada. Las asociaciones entre las variables clínicas/demográficas y el desarrollo de disfunción eréctil se analizaron estadísticamente. Resultados: Se incluyó un total de 64 pacientes en el estudio. La edad media de los pacientes fue de 43.0 ± 12.2 años. En todos los casos se realizó exploración quirúrgica temprana. A los 6 meses, el 21.9% de los pacientes presentaron disfunción eréctil postoperatoria significativa. El análisis univariante reveló que la edad fue la única variable significativamente asociada con la disfunción eréctil (p = 0.0076). El análisis de la curva de características operativas del receptor (ROC) identificó ≥50 años como el punto de corte de edad óptimo para predecir la disfunción eréctil (Área bajo la curva (AUC): 0.727; sensibilidad: 57.1%; especificidad: 82.0%). No se encontraron otras variables clínicas significativamente asociadas con la disfunción eréctil postoperatoria. Conclusiones: A pesar de la intervención quirúrgica temprana, una proporción considerable de pacientes desarrolló disfunción eréctil tras la fractura de pene. La edad fue la única variable significativamente asociada con la función eréctil a largo plazo en nuestro análisis. Estos hallazgos enfatizan la importancia de la edad tanto en el asesoramiento preoperatorio como en la planificación del seguimiento postoperatorio.

Penile fracture; Erectile dysfunction; Postoperative complications; Functional outcomes

Palabras Clave

Fractura de pene; Disfunción eréctil; Complicaciones postoperatorias; Resultados funcionales

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