Can You Break Your Penis? Penile Fractures Explained
The Unmentionables is a series that answers common questions we all have about our bodies but are sometimes afraid to ask.
Key takeaways:
Penile fractures are injuries to the penis that typically occur during sexual intercourse or masturbation. Given the sensitive nature of the condition and nature of injury, most people don’t talk about it.
Penile fractures are uncommon, but many people are curious about how they happen, especially so they can prevent the injury from happening to them.
Penile fractures are an emergency. And they usually require prompt surgery to avoid long-term injury. So knowing the signs and symptoms is an important part of getting the right care.
A penile fracture can occur when an erect penis is forcibly bent. The word “fracture” is slightly misleading — given there is no actual injury to a bone. It is actually an injury to an inner layer of tissue that holds blood inside the penis. Although it’s rare, a penile fracture is more likely to occur in certain sex positions. And it needs prompt medical treatment to prevent permanent dysfunction of the penis.
What is a penile fracture?
A penile fracture is a rip or tear in an inner lining of the penis called the tunica albuginea. Inside the penis, there are two important structures:
1) Corpora cavernosa: These are basically sponges that fill with blood during an erection.
2) Tunica albuginea: This is a lining that surrounds the corpora cavernosa, and it holds the blood in place when the penis is erect. This is what makes the penis physically stiff during an erection.
When a penile fracture occurs, the penis can no longer hold the shape of an erection.
How does a penile fracture happen?
Penile fractures occur when there is a large amount of force applied to the penis. And it only occurs when the penis is erect. When the penis is flaccid (soft), the tunica albuginea is flexible. But when erect, the tunica albuginea is tense and can’t change shape as easily. So if an abnormal force is applied in just the wrong way, it can tear.
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It may help to think of the tunica albuginea like a water balloon. If a balloon only has a small amount of water, it isn’t easy to pop. But if it’s filled up, it breaks more easily.
Usually, penile fractures happen during sex or masturbation. This is because these are situations where the penis could be accidentally bent with force while it is erect. For example, this can happen if the penis slips out of the vagina during sexual intercourse and then receives the impact of a forceful thrust.
What are symptoms of a penile fracture?
The symptoms of a penile fracture will be immediately obvious. And they will start right after the injury. These symptoms are:
Pain, which is usually severe
Immediate loss of the erection
Bruising or discoloration to the penis
A bend in the penis
An audible “snap” when the injury occurs
Difficulty urinating if the tube that carries urine (called the urethra) is injured
How is a penile fracture diagnosed and treated?
Someone who injured their penis in this way should see a healthcare provider right away. It’s usually easy to diagnose based on the description of how the injury occurred and a physical exam of the penis. Sometimes testing may be needed to check for a penile fracture. This can be done with an ultrasound or an MRI.
If someone is diagnosed with a penile fracture, a urologist will evaluate them. The injury usually needs surgery to explore the extent of the injury and to repair the tunica albuginea. When not treated, a penile fracture can lead to a permanent curve in the penis and erectile dysfunction. Delaying medical care for even 8 hours may increase the risk of erectile dysfunction. One study showed that 80% of people who did not get surgery had long-term dysfunction of the penis. So it’s a good idea to seek medical care as soon as possible.
The bottom line
Penile fractures are rare injuries. But if they do occur, it’s important to see a healthcare provider right away. Someone with this injury might be embarrassed or nervous about their injury. But penile fractures are serious and need urgent treatment. And healthcare providers understand how serious these injuries are. Getting treatment quickly will not only help to relieve any associated pain, but it’ll also prevent permanent damage to the penis.
Why trust our experts?
The Unmentionables is a series that focuses on common curiosities about our bodies that, at some point, have been labeled as taboo, shameful, or embarrassing. But these are important questions we all have about our health, and we should be able to ask them. This series aims to dispel the stigma, normalize the discussion, and openly address these important health topics.
Don’t be shy. Someone else has the same question, so ask away!
References
Bozzini, G., et al. (2018). Delaying surgical treatment of penile fracture results in poor functional outcomes: Results from a large retrospective multicenter European study. European Urology Focus.
Falcone, M., et al. (2018). Current management of penile fracture: An up-to-date systematic review. Sexual Medicine Reviews.
Morey, A. F., et al. (2020). Urotrauma guideline (2020). The Journal of Urology.
Rodriguez, D., et al. (2019). Epidemiology of penile fractures in United States emergency departments: Access to care disparities may lead to suboptimal outcomes. The Journal of Sexual Medicine.
Yapanoglu, T., et al. (2009). Seventeen years' experience of penile fracture: Conservative vs. surgical treatment. The Journal of Sexual Medicine.
