An episode of American hospital drama Grey’s Anatomy screened in the US last week has led to thousands of young men scouring the internet to find out if it really is possible for a man to fracture his penis, as happened to on-screen Consultant Mark Sloan (aka McSteamy, played by Eric Dane) when he had sex in the on-call room with intern Lexie Grey (played by Chyler Leigh). The episode in question was Season 5 Episode 13, “Stairway to Heaven”.
The answer, is yes it is possible for a man to fracture his penis, although it is rare (Jagodič, Erklavec et al, 2007).
“Penile fracture” occurs when an erect and rigid penis suffers a blunt trauma; it is primarily a rupture of the tunica albuginea, the fibrous tissue that envelopes the corpus cavernosum, the part of the penis that swells with blood to make an erection. The blood then leaks into the surrounding parts of the penis, causing bruising, abnormal swelling and loss of erection.
The rupture can also affect the urethra and the corpus spongiosum, a firm spongy tissue that sheaths the urethra and stops it closing during ejaculation.
The tunica albuginea is a very strong fascia tissue: its job is to encase and protect, rather like the fascia that encloses our whole body from head to toe. Unfortunately it is at its most vulnerable when the penis is erect, because it stretches and thins, sometimes to one tenth of its normal thickness.
The injury usually occurs during sexual intercourse, although it can also happen at other times. It is accompanied by a sound of cracking or popping, followed by intense pain and swelling that distorts the shape of the penis, making it very difficult if not impossible to urinate. Sometimes just one side of the penis is affected, sometimes both.
Treatment usually comprises ice packs, anti-inflammatories and painkillers, and it often requires surgery to repair the tear.
Coco Ballantyne of Scientific American spoke to Hunter Wessells, chair of the urology department at the University of Washington School of Medicine in Seattle, about the condition. The hospital he works at also happens to be the setting for Grey’s Anatomy.
He said penile fracture most often occurs when the man attempts to penetrate the “normal location” but instead encounters a more solid surface, for instance the perineum. It can also happen during intercourse when the woman is on top, or during “sexual acrobatics”, and he recounts the case of a patient that was admitted with penile fracture after trying to penetrate his wife with a “flying leap”.
Wessells said if surgery is required to repair the tear, the patient has a general anasthetic and the surgeon cuts the skin of the penis, finds the edge of the tear and closes it up with sutures. Sometimes the tears are extensive and need about 10 stitches he said. The procedure takes about an hour and the patient can usually resume a normal sex life after a month or so.
Wessells said he has seen a few dozen cases in 20 years of practice, and at the University of Seattle they have about 2 cases a month, so it is not very common.
However, the risk of incurring penile fracture is not confined to sexual intercourse. A man could fall downstairs and suffer penile fracture if he was erect at the time and landed on his penis, explained Dr Darius Paduch during an interview with ABCNews.com. Paduch is a urologist at New York Presbyterian-Weill Cornell Medical Center and has treated multiple penile fractures.
Paduch said he had treated an American football player who suffered a penile fracture during a game: his penis was erect when it collided with great force into the helmet of another player.
“A case of penile fracture with complete urethral disruption during sexual intercourse: a case report.”
Klemen Jagodič, Marko Erklavec, Igor Bizjak, Sandi Poteko, and Helena Korošec Jagodič.
J Med Case Reports. 2007; 1: 14.
Published online 2007 May 2.
doi: 10.1186/1752-1947-1-14.
Click here to read the Article.
Sources: Scientific American, ABC News, J Med Case Reports.
Written by: Catharine Paddock, PhD