Delayed Presentation of Penile Fracture. It’s 7 Days Later, Do You Operate?

Delayed Presentation of Penile Fracture. It’s 7 Days Later, Do You Operate?

Today at the 24th Annual SMSNA Annual Fall Scientific Meeting, Dr. Raúl Fernández-Crespo and Dr. Omer Raheem presented opposing viewpoints on the topic: Delayed Presentation of Penile Fracture. It's 7 days later, do you operate? Dr. Fernández-Crespo spoke in favor of operating 7 days after a penile fracture, while Dr. Raheem spoke against it.

First, Dr. Fernández-Crespo advocated for surgical intervention seven or more days after a penile fracture, citing studies that demonstrated successful outcomes with delayed operations. He emphasized the advantages of this approach, including the ability to provide specialized referrals, optimize medical care, and wait for penile swelling to subside. Dr. Fernández-Crespo stressed the importance of addressing the problem rather than leaving it untreated, asserting that it's better to act late than never.

On the opposing side, Dr. Raheem argued for a non-operative approach. He expressed concerns about the low quality of research in the field and called for more robust data to guide surgical decisions for penile fractures. Dr. Raheem highlighted the potential for erectile dysfunction and penile curvature even with surgical intervention, pointing out significant variability in postoperative sexual dysfunction and penile deformities. Contrary to the delayed approach, he referred to prior literature that favored early intervention within 36-48 hours, and emphasized that penile fractures often heal without treatment.

The debate underscores the complexity of addressing penile fractures, with each perspective offering unique insights and raising important considerations for medical practitioners faced with this challenging scenario. The need for further research and a comprehensive understanding of the outcomes associated with different intervention timings emerged as key takeaways from this intriguing session.

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