Beyond conventional wisdom: unexplored risk factors for penile fracture

Background: Sexual intercourse is a predominant cause of penile fractures (PF).

Aim: To evaluate the relationship between body metrics and the severity of PF, identifying how anthropometric factors of patients and their partners influence the incidence and severity of PF.

Methods: This study analyzed 47 patients with PF over 9 years across multiple centers. Demographic and anthropometric data were collected for both patients and their partners. Injuries were categorized by the sexual position or activity causing them, including partner-related positions (man-on-top, woman-on-top, and doggy-style) and isolated actions (rolling-over, blunt trauma, masturbation, or manipulation). Statistical analysis was performed using the χ2-test.

Outcomes: The study aimed to uncover correlations between body metrics and the risk profile for PF, focusing on body mass index (BMI), weight, height, and age.

Results: The majority of PFs occurred during sexual activities (74.5%), particularly in “doggy” and “man-on-top” positions. Urethral involvement was observed in 10.6% of cases. Significant correlations were found between patient and partner ages (r = 0.915), patient BMI and weight (r = 0.874), patient height and weight (r = 0.502), and partner weight and BMI (r = 0.805). Higher BMI in patients was linked to delayed hospital visits (r = 0.377), and frequent sexual activity was strongly correlated with urethral complications (r = 0.727).

Clinical implications: These findings emphasize the importance of considering body metrics in assessing PF risk and could guide future preventive strategies and clinical interventions.

Strengths & limitations: The study’s strength lies in its comprehensive analysis of anthropometric factors and their correlation with PF severity. Limitations include a relatively small sample size and the potential for reporting bias in sexual activity data.

Conclusion: The study confirms sexual intercourse as the main cause of PF and highlights significant links between anthropometric factors and fracture severity. Higher BMI and weight in partners are associated with more centrally located fractures and urethral injuries, particularly in taller patients or those with larger partners.