Role of sexual partner and social networking in fracture penis aetiology

Abstract

Introduction: Fractured penis is a well-recognised urological emergency resulting from blunt trauma to the erect penis. The incidence and severity of penile fracture mostly relies on the method of sexual practice adopted by the couple which again depends on their psychosocial behaviour. The aim of this study was to analyse the different circumstances that accompany this injury in relation to severity, such as associated urethral injury, and to address the contribution of the patients’ partners in possible aetiologies and prevalences. Methods: A prospective observational study over two years of all patients presenting to our institution with a fractured penis. All patients who were subjected to detailed history and clinical examination, which included educational status, profession and access to internet. The patients’ partners were asked the same questions as well as a sexual behaviour questionnaire to grade their level of sexual appetite. Results: Thirteen patients were included; all patients were married with an average age of 37. The coital positions associated with this injury were female on top position (four cases), T position (three cases), knee–elbow coital position (two), male superior coital position (two) and lateral coital position (one); one couple were unable to explain the exact position. Overall, 11/13 (85%) female partners showed moderate to high sexual appetite and only two (15.5%) showed low appetite. Out of the 26 patients and partners, only nine (34.6%) had a profession related to computers, but 16 (61.5%) of them had access to the internet. Conclusions: High aggressive sexual behaviour may be a factor for vigorous sexual activity and increase the chance of penile injury. The exact role of social networking though not well established may precipitate more injury through the learning of different coital positions; ‘female on top position’ may be related to a higher incidence of fractured penis.