Penile Fracture: What It Is, Symptoms, and Treatment

At the time of injury, you might hear an audible cracking, snapping, or popping sound. You may also feel considerable pain.

Symptoms of a penile fracture include:

• Pain

• Rapid detumescence (loss of erection)

• Bruising or hematoma (a pool of clotted blood)

• Swelling of the penile shaft

• Bleeding at the tip of the penis

• Penile curvature away from the site of injury

Swelling of the soft tissues and purplish bruising can make the penis take on the appearance of an eggplant. The resemblance is so uncanny, in fact, that healthcare providers often refer to it as the “eggplant deformity.”

The Buck’s fascia could also be torn — that’s the deep layer of connective tissue surrounding the tunica albuginea — in which case blood and urine may leak into the scrotum, perineum, or suprapubic region (the above the public bone and below the belly button). This leakage can create a “butterfly” pattern.

If you also injure your urethra, which happens in roughly 20 percent of penile fracture cases, you might experience additional urinary symptoms. Signs of urethral injury include blood at the meatus (the opening at the tip of the penis where urine comes out), trouble peeing, and blood in the urine.

How can you break a penis? A few ways, potentially.

To answer this question further, we need to first go over how an erection works. Here’s a quick rundown:

• When you get an erection, each corpus cavernosum (spongy penile tissue column) fills with blood, making your penis rigid and ready for action.

• Meanwhile, the fibrous layer surrounding the corpora cavernosa, the tunica albuginea, supports the erectile tissues.

Although strong, the tunica albuginea gets very thin during an erection due to the expansion. This thinness makes it more vulnerable to tearing.

Can You Break Your Penis During Sex?

It’s possible — at least, in a sense.

The most common cause of penile fractures is sexual intercourse. You don’t even have to be having rough sex to experience this injury.

If your erect penis slips out of your partner’s vagina mid-thrust, for instance, you could slam it directly into the perineum or pelvic bone, causing a rupture of the tunica albuginea — i.e., a broken penis.

The sexual position most likely to cause this type of penile trauma is a rear-entry position (doggy-style). However, cases have also been reported from sex with the woman on top and even in the classic missionary position.

Can You Break Your Penis Masturbating?

It’s less common but possible.

Other potential causes of a penis fracture include:

• Falling and landing on your penis

• Rolling onto your penis in your sleep

• Taqaandan, a cultural practice in which a man forcibly bends his penis downward to stop an erection

• Hitting a toilet seat

• Being thrown against a saddle knob

Some guys might be more at risk for a penile fracture than others.

Penis Fracture Risk Factors

Penile fractures are most common in middle-aged men. According to numerous studies, the average age of penis fracture patients is 30 to 50 years old.

Though a fracture of the penis can happen to anyone, you may be more prone to injury if you engage in vigorous sexual activity or prefer the doggy-style position.

Heading into the hot season or planning a long weekend? Be careful — some research shows that penile fractures happen more frequently on weekends and during the summer months.

With prompt treatment, the prognosis of a fractured penis is good. Remember, a penile fracture is an emergency and should be treated as such.

Even if you didn’t hear a pop or crack during sex, call your healthcare provider right away if you’ve injured your penis. There’s a high risk of complications if you delay treatment.

To diagnose a penile fracture, your provider will perform a physical exam and ask about your symptoms.

If they can’t diagnose you based on their initial assessment, they might order one of these tests:

• Penile ultrasound

• Cavernosography, an X-ray in which dye is injected into penile blood vessels

• Magnetic resonance imaging (MRI)

• Retrograde urethrography, an X-ray of the urethra and bladder if a urethral rupture is suspected

If you didn’t hear a cracking sound at the time of injury, it’s possible you don’t have a penile fracture. You may have injured the dorsal veins and arteries of your penis, which control blood flow in and out.

The main treatment option for a penile fracture is surgical repair. It has a success rate of 92 percent, while conservative management (that is, non-surgical) is only successful 59 percent of the time.

Conservative management includes at-home care you do yourself, like applying cold compresses to the injury and taking anti-inflammatory drugs or antibiotics to relieve swelling and prevent infection.

Surgery for Broken Penis

Surgical intervention is the treatment of choice for a penis fracture — as noted, it’s shown to be the most effective option.

Surgical treatment typically involves making an incision along the penile shaft or at the base of the penis to remove the hematoma and repair the injured tunica albuginea.

The surgeon may opt for degloving, when the penile skin is pulled back, to see the injury clearer and prevent scarring along the shaft.

After locating the tear, the surgeon will repair it with sutures (internal stitches).

Surgical exploration is a good way for a urologist to check if the urethra has been damaged. If so, smaller sutures will also be used to repair the injury, and a catheter will be inserted to assist with voiding (help you pee).

If there are no complications, the average hospital stay for penile fracture surgery is four days. Delaying treatment can lead to a longer stay.

There will likely be several follow-up visits to ensure the wound is healing properly.

You’ll probably be asked to refrain from sexual intercourse for six to eight weeks to avoid painful erections and allow time for healing. You might also be prescribed medication to suppress erections.

Like any surgery, there may be some complications, especially if you delay treatment. More on this below.

Here’s what to consider about long-term outcomes and complications for a penile fracture:

• Complications of penile fracture. Without prompt and appropriate treatment, penile fractures can lead to various complications, including erectile dysfunction (ED), curvature of the penis, and scar tissue formation.

• Potential urethral problems. Other problems can include stricture (narrowing of the urethra) and urinary disorders if the penile fracture also causes urethral injury.

• Risk of complications. If you try to tend to the injury yourself with conservative management, research shows your risk of experiencing complications is around 30 percent. Meanwhile, immediate surgical repair is associated with a 10 percent risk of complications.

• Timely treatment. You shouldn’t stop for snacks first, either. One study showed that a delay of around eight hours significantly increased post-op ED rates. A delay of more than 24 hours is even worse, increasing your risk of wound infection, postoperative fever, penile curvature, a longer hospital stay, and ED symptoms one year later.

• Peyronie’s disease. Some research also shows a higher risk of Peyronie’s disease for men who’ve had penile fractures. This condition is when scar tissue forms under the skin of the penis within the deeper tissues, resulting in curved (and often painful) erections.

• Sexual function issues. Though sexual dysfunctions like ED can arise from a penile fracture, some patients experience anxiety over their sexual performance and may require counseling. Other sexual complications reported after penile fracture include decreased libido (lowered sex drive) and ejaculatory dysfunctions.

Your healthcare provider may prescribe ED medications like PDE5 inhibitors to help improve erectile function after penile fracture. These drugs include:

• Sildenafil (generic Viagra^®)

• Tadalafil (Cialis^®)

• Vardenafil (Levitra^®)

• Avanafil (Stendra^®)

In one study of 25 men with penile fractures, nine had ED after surgical repair. These nine men were prescribed daily tadalafil at a 5-milligram dose for at least one month or until they were able to have normal erections again.

Five out of the nine patients (55 percent) had improved erections after one month of tadalafil treatment. And only four (44 percent) needed an additional month of treatment.

There are some precautions you can take to reduce the risk of experiencing a penile fracture. They include:

• Using lube when you have sex

• Avoiding rough or vigorous thrusting

• Not rolling over in bed to face upward or out when you have an erect penis

• Never attempting to stop an erection by forcefully bending it downwards

This might seem like a lot to remember while getting some action. But if you’re careful, preventing a broken penis really isn’t all that hard.

If you think you have a penile fracture, time is of the essence. Stop reading this article and seek medical care.

Here’s what to remember about penis fractures:

• Hearing a popping sound is a sign you’ve fractured your penis. Other common symptoms include bruising, swelling, and an immediate loss of your erection.

• You may have a urethral injury. A penile fracture is a tear in the tunica albuginea, but you could also injure your urethra in the process. Some signs include trouble urinating or bleeding from the urethra.

• Penile fractures are a medical emergency. The longer you delay treatment, the higher your risk of long-term complications like erectile dysfunction, a curved penis, and scar tissue formation.

• Surgery is often required. The most effective treatment for penile fractures is surgery. A urologist will make an incision in your penis to repair the injury.

If you’ve injured your penis, don’t let embarrassment or fear keep you from getting the help you need. Prompt treatment is the best way to prevent long-term injury and complications.

If you’re struggling with ED or other sexual dysfunctions after a penile fracture, do a virtual consultation with a healthcare provider to find out what treatment options are available.