A man in the UK appears to be a medical first, though probably not in the way he would have wanted. His doctors say he’s the first known person to have had his penis broken vertically during sex. Despite the odd injury, though, the man has fully recovered.
A broken penis, or penile fracture, is more accurately described as a tear starting from the tunica albuginea, the protective layer surrounding the erectile tissue that pump blood to the penis. The reason why it feels like a broken bone is that most injuries happen during sex, when a fully erect penis is bent too far and/or with too much force and buckles under the pressure, which then causes blood in the penis to leak out. When that happens, it’s almost always accompanied by a loud popping sound along with quickly formed bruising and swelling, again much like a broken bone. The injury also causes immediate detumescence, or the loss of an erection. It’s thought to be uncommon, though probably underreported due to embarrassment.
The urologists behind this case study, published Tuesday in BMJ Case Reports, say their patient’s injury was even rarer than the typical variety. Like most cases, the 40-year-old man had gotten hurt during sex, specifically when his penis “buckled against his partner’s perineum” (more colorfully known as the taint). But he didn’t show many of the symptoms of a classic penile fracture. He hadn’t heard a loud popping when it happened, for instance, nor did he develop a “rolling” sign, which is when the skin of the penis can be rolled over a large bruise that forms on it. His penis was also only moderately swollen and he didn’t immediately lose his erection; instead, it gradually faded.
The strangeness was enough to convince the doctors to order an MRI, not usually needed in these cases. And when the test came back, it confirmed that the man’s penis had a three-centimeter-long vertical tear along the right side, around the middle of the shaft, rather than a transverse tear, or one that’s horizontal. Near as they can tell, it’s the first ever reported injury of its kind. Unfortunately (or maybe fortunately for the squeamish readers out there), the doctors didn’t take any photos of the injury, due to restrictions related to the pandemic at the time.
“In July 2020, a PubMed literature review confirmed that all documented cases in the English language report a ‘transverse’ fracture of the tunica albuginea,” they wrote. “In turn, we present the first documented case of a vertical penile fracture, confirmed on MRI, sustained by a 40-year-old man during sexual intercourse.”
Given the man’s milder symptoms, the doctors speculate that a vertically broken penis might be noticeably different in presentation and long-term outcomes compared to the more typical injury. A penile fracture is a serious medical emergency that can lead to disability, which is why it’s recommended that doctors treat it within 24 hours. Even with treatment, usually surgery to repair the tear and stop the bleeding, lasting complications can include permanent erectile dysfunction, a scarred and narrowed urethra, or a much more curved penis than before.
Luckily, in this case, the surgery seemed to be a complete success. And it didn’t take long for the man to recover without any lingering problems. According to the report, the doctors do plan to keep an eye on the man.
“In terms of long-term outcomes, we will compare this patient’s recovery to that of the literature,” they wrote. ”Reassuringly however, this patient was able to resume sexual activity within 6 months of the injury, achieving erections of the same quality to those prior to the injury, denying any penile curvature or significant palpable scarring.”
By the way, in case you’re wondering, risk factors for the classic broken penis include being over 40 and having sex “doggy-style” or with a women on top.