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Volume 23, Issue 3 (May 2021) 23, 236–239; 10.4103/aja.aja_70_20

Risk factors for penile fracture compared with a surgical control cohort in the United States: the role of substance abuse

Nathaniel Christian-Miller1, Andrew T Lenis2, Katherine E Fero2, Josef Madrigral1, Sriram V Eleswarapu2, Karim Chamie2, Peyman Benharash1

1 Cardiovascular Outcomes Research Laboratories (CORELAB), Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA
2 Department of Urology, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA

Correspondence: Dr. KE Fero (kfero@mednet.ucla.edu)

Date of Submission 13-Jul-2020 Date of Acceptance 13-Sep-2020 Date of Web Publication 27-Nov-2020


Penile fracture (PF) is a surgical emergency. Given its rarity, we queried a national cohort over an 11-year period to study the temporal and demographic variations in presentation, evaluation, and management of patients with PF compared with a cohort of control patients. The National Inpatient Sample was queried between the years 2005 and 2016 for patients with a diagnosis of PF. Appendectomy patients were selected as a control cohort, given the non-discriminatory nature of this disease. Clinical and demographic data of the patients were compared with that of controls. Presenting symptoms, rates of surgical repair, and rates of associated surgical procedures were evaluated in the PF cohort. During the study period, 5802 patients were hospitalized for PF. The annual incidence of PF remained unchanged at 1.0–1.8 cases per 100 000 hospitalizations over the study period. Compared with the control cohort, PF patients were more likely to be younger (38.7 years vs 41.2 years, P ≤ 0.001), have lower rates of comorbidities except erectile dysfunction (1.4% vs 0.1%, P ≤ 0.001), and were more likely of Black race (25.4% vs 6.2%, P ≤ 0.001). Notably, PF patients had significantly higher rates of substance abuse (26.4% vs 18.1%, P ≤ 0.001), despite no difference in the diagnosed psychiatric disorders. PF rarely presented with hematuria (3.5%); however, urethral evaluation was performed in 23.1%, most commonly with cystoscopy (19.2%). PF occurs more commonly in a younger, healthier male population, and among minorities. Importantly, rates of substance abuse appear to be higher in the PF cohort compared with those of controls.

Keywords: epidemiology; penile fracture; penis; urethra; urethral injury

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