Penile fracture is a serious injury that happens in an erect penis and requires immediate medical care, as it can lead to sexual complications if not treated properly.
Although there is no bone in the penis, the term “penile fracture” became popular to describe cases in which trauma occurs during an erection: a sudden tear of the tunica albuginea around the corpora cavernosa, causing immediate pain and possible sequelae.
The condition is relatively rare. There are no incidence data for Brazil, but a multicenter study published in the The Journal of Sexual Medicine estimated an incidence of 1.02 cases per 100,000 men per year, with 8,000 emergency room visits in the United States between 2010 and 2014.
Penile fracture needs urgent medical attention to prevent serious complications. Below, understand the key aspects of this condition and how to prevent it.
What is a penile fracture?
A penile fracture is defined by a tear of the tunica albuginea that surrounds the corpus cavernosum, with immediate loss of erection due to trauma or strong impact on the erect penis.
This tear occurs mainly during vigorous sexual activity. The “doggy style” position is among the riskiest in Brazil, according to a report published in the International Brazilian Journal of Urology.
In general, the causes of penile fracture are linked to trauma or excessive pressure directly on the erect penis, such as in the following situations:
- Falls onto hard objects;
- Traffic accidents;
- Forcing the organ while it is erect;
- Compulsive masturbation;
- Sleeping face down during an involuntary erection.
Penile fracture symptoms
Symptoms usually appear quickly and can be alarming, but it’s important to know them and seek medical help calmly:
- A popping sound at the moment of the tear;
- Intense pain;
- Sudden loss of penile rigidity (detumescence);
- Hematoma;
- Swelling (edema).
If a penile fracture is suspected, as an emergency measure, apply ice to the area and go to the emergency department immediately.
What does penile fracture pain feel like?
- “Penile fracture pain is unforgettable.”
This is how many patients describe the moment of injury. The pain arises exactly when the corpora cavernosa rupture—intense, sudden, and stabbing—making the person stop immediately.
It may be described as a popping sensation accompanied by an audible “crack.” The sound occurs because internal penile tissues tear abruptly.
After the initial tear, pain often persists with swelling and hematoma formation, which increases penile sensitivity.
In severe cases, penile fracture can involve urethral injury. If this occurs, there may be difficulty or inability to urinate, sometimes with blood in the urine.
Diagnosing a penile fracture
In most cases, the clinical picture is so typical that diagnosis is based on patient history and physical examination.
When in doubt or to assess associated injuries, tests such as Doppler ultrasound and urethrography may be used.
Without prompt care, a penile fracture can lead to serious consequences for sexual function.
Treating a penile fracture
Because of the risk of serious and lasting complications, penile fracture is a urologic emergency that requires urgent evaluation and treatment to preserve erectile function and avoid deformities.
According to the clinical guide for health professionals StatPearls, the treatment of penile fracture is surgical, with timely repair of the tunica albuginea and urethra (when involved), and placement of a catheter if needed.
Surgery is done under anesthesia. First, an incision is made to expose the injured area; the surgeon identifies the tear in the corpora cavernosa and any associated lesions, such as urethral damage.
Once located, the tear is repaired with fine, absorbable sutures to minimize scarring and promote healing.
If the urethra is injured, it is repaired during the same procedure.
After internal repair, the skin incision is closed and a dressing is applied to protect the area and reduce swelling.
The patient is monitored in recovery until the anesthesia wears off.
There is no specific medication-only cure. In some cases, medications may be used to prevent postoperative infection.
In selected cases—small tears without deformity or urethral injury, or when surgery is contraindicated—conservative care may include immobilization, local compression, and anti-inflammatory/analgesic medications.
Some patients may receive medicines to suppress erections.
However, this approach carries higher risks of future complications and is reserved for restricted situations.
Recovery and possible sequelae after a penile fracture
The earlier the surgery, the better the prognosis.
A recent publication in Therapeutics and Clinical Risk Management warns that if more than 12.5 hours elapse between trauma and surgery, the risk of erectile dysfunction increases.
Most patients are discharged the same day or the following day. Follow-up is essential to monitor healing and detect complications.
Recovery time varies, but typically follows these steps:
- First days: pain and swelling control with prescribed analgesics; rest is recommended.
- Two to four weeks: ice and elevation to reduce swelling and aid healing. If a catheter was placed, it is often removed during this period.
After about four to six weeks, many patients notice significant improvement. It is important to follow all medical recommendations to avoid complications.
Sexual abstinence is usually recommended for at least 6–8 weeks to allow complete tissue recovery.
With appropriate treatment and follow-up, recovery often occurs within 3–6 months, depending on injury severity and individual response.
Some patients may have temporary or lasting sequelae, such as:
- Fibrosis leading to penile curvature;
- Scarring on the penis;
- Painful erections;
- Urinary symptoms;
- Emotional impact.
Sex life after a penile fracture
In general, with proper treatment and follow-up, it is possible to resume sexual function, especially when medical care occurs early.
However, some patients may experience sequelae that affect sexual life. Associations with erectile dysfunction, curvature, and negative feelings can occur and should be addressed with a specialist.
With appropriate treatment, patients may experience functional and cosmetic improvement, depending on injury severity and individual response to surgery.
How to prevent a penile fracture?
Prevention is key to avoid intense pain and complications. A few measures may significantly reduce risk:
- Be careful during sex: most fractures happen during vigorous intercourse. Avoid abrupt movements and risky positions that put excessive pressure on the penis.
- Communication: ensure your partner is aware of movements. If discomfort or pain occurs, stop and adjust position or intensity.
- Avoid bending an erect penis: never push it downward; this can create extreme pressure and cause a tear.
- Monitor penile health: if you notice pain, curvature, or difficulty maintaining an erection, consult a physician.
- Use erection medications with caution: drugs for erectile dysfunction should be used under medical guidance.
When to see a urologist
If during an erection you notice a sudden pop, immediate intense pain, loss of rigidity, swelling or hematoma, seek emergency care as soon as possible—preferably at a facility with a urologist.
If this isn’t possible, go to the nearest emergency department, as this emergency should be treated promptly to reduce the risk of erectile dysfunction and curvature.
After emergency care, schedule a follow-up with a urologist to assess the case in detail and, if needed, minimize sequelae.
Questions? Contact Dr. Paulo on WhatsApp
Penile fracture has treatment, as do any sequelae that may occur.
Many patients show good recovery of penile function with proper treatment and follow-up. If you have concerns or would like a professional evaluation, speak with Dr. Paulo Egydio.
The urologist has over 25 years of experience treating erectile dysfunction and penile curvature, offering specialized care..
Contact via WhatsApp or book an appointment to receive initial guidance.
