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Broken penis syndrome

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We all have embarrassing questions that we’re too afraid to ask. Have no fear in this weekly series Dr Rakesh Newaj tackles broken penis syndrome.

Wildest Facts: There is an erotic dance popular in Jamaica called “daggering” - It was banned from TV after causing too many broken penises.

Daggering is a form of dance originating from the Caribbean. The dance incorporates sexual and other forms of frantic movement. It is a more explicit version of Grinding and Perreo and often features acrobatic stunts where one partner leaps from a height onto the other dance partner and then commences to engage in exaggerated simulated sexual intercourse.

Just to make it clear the penis is not a bone, hence it is tearing that takes place not a broken bone, but it gets referred to as broken penis syndrome

What exactly is broken penis syndrome?

It's what we call penile fracture. It is a severe form of bending injury to the erect penis that occurs when a membrane called the tunica albuginea tears. The tunica albuginea surrounds the corpora cavernosa, specialized spongy tissue in the core of the penis that fills up with blood during an erection. When the tunica albuginea tears, the blood that is normally confined to this space leaks out into other tissues. You get bruising and swelling.

What are the signs of penile fracture?

Usually there will be a popping sound. If someone has severe pain (in the penis), especially associated with bruising, swelling and loss of erection, he should seek emergency care.

How exactly does penile fracture happen?

Any situation during intercourse when there is thrusting and when the penis, instead of penetrating its normal location, is hitting some solid structure (such as the perineum). Usually this occurs during regular vaginal sex with the woman on top, but it can happen in the missionary position or during sexual acrobatics. We had this patient who suffered penile fracture after running across the room and trying to penetrate his wife with a flying leap.

What can doctors do to fix the tear?

We put the person on general anaesthesia and open up the skin through one or more incisions in the penis. Then we find the edge of the tear and close it up with sutures. Sometimes these tears are extensive and span half the circumference of the penis (usually the tears are crosswise), requiring about 10 stitches. Then we close everything up. The operation takes about an hour, and most people go home right after. Most can resume sex in about a month (after the wound has healed).

What happens if you don't get this operation?

There are probably some cases in which you can get away with not operating on it but, in general, you will be more likely to have future complications. Partial or complete tearing of the tunica albuginea can lead to long-term scarring, and the buildup of scar tissue can lead to erectile dysfunction or penile deviations, such as chronic curvature of the penis (causing an erection that bends sideways—sometimes at a 45-degree angle).

How common is penile fracture, and who is most likely to suffer from it?

We don't have any incidence data like that, but we know there are many case reports in the literature. I've seen dozens of case when working in casualty and y friends the urologists will obviously see it regularly.

Young men in their 20s and 30s, who tend to be engaged in more vigorous sexual activity face the highest risk, but we do see it in men in their 40s and 50s. (The latter's lower risk) might be because older men have decreased frequency and vigor of sexual activity and the tissue in their penises tends not to get quite as rigid.

If the penis bends but the tunica albuginea doesn't tear, could this lead to injury as well?

There are probably many men who have had the experience of missing the penetration spot and bending the penis. Most of these cases are nothing to worry about. But there are some people who have bending injuries (but not full-blown tears) who may go on to develop Peyronie's disease, a condition in which the penis is bent due to the build-up of scar tissue, but it's not yet clear whether this is the cause of the disease.

This and other embarrassing questions will be answered weekly by sexologist, Elna McIntosh and dermatologist, Dr Rakesh Newaj.

Visit the InterSEXions Facebook page and also keep a lookout for the SABC1 TV series coming in February.

(January 2013)

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