Damage and trauma to the penis

Damage and trauma to the penis in 1% of cases is combined with damage to both testicles.

ICD 10 codes

• S31. Open wound of abdomen, lower back and pelvis.
• S31.2. Open wound of penis.
• S38. Crushing and traumatic amputation of part of abdomen, lower back and pelvis.
• S38.0. Crushing injury of external genitalia.
• S38.2. Traumatic amputation of external genitalia.

Classification of damage and injury to the penis

According to the type of injury to the penis, the following are distinguished:

• closed (blunt): contusion, fracture, dislocation and strangulation of the penis, which make up 80%:
• open (penetrating): lacerated-bruised, scalped, bitten, stab-cut, gunshot) - about 20%;
• frostbite;
• thermal damage to the penis.

Penile injuries and trauma are also divided into closed (trauma not caused by a piercing or cutting object) and open (injuries caused by piercing or cutting objects and bites). Nowadays, the classification of penile injuries of the European Urological Association (EVA guidelines 2007) is becoming increasingly widespread abroad. It is based on the classification of the Committee on Organ Injury Scalling of the American Association for the Surgery of Trauma. It is believed that this classification makes it possible to distinguish between patients with severe penile injuries who should be treated surgically and patients whose injuries can be treated conservatively.

Injuries to the external genitalia are more common in men not only because of their external location, but also because men are more often involved in traumatic sports (rugby, hockey, cycling, motorcycling, wrestling, alpine skiing and other active sports). The risk group includes patients with mental illnesses, people of non-traditional sexual orientation, transsexuals. Such injuries are also associated with injuries with cutting objects and gunshot wounds, the frequency of which increases annually. Iatrogenic injuries and trauma to the penis are observed during circumcision, reconstructive surgeries for hypospadias and bladder exstrophy, manipulations for priapism. Rare injuries to the penis include bites.

Classification of penile injury and trauma by severity according to the European Urological Association (EUA guidelines 2007)

Severity	Damage characteristics
I	Tissue rupture/concussion
II	Rupture of the fascia of the Beech (corpus cavernosum) without tissue loss
III	Tissue rupture (avulsion) (rupture of the glans penis involving the external opening of the urethra), defect less than 2 cm of the cavernous body or urethra
IV	Defect greater than 2 cm of the corpus cavernosum or urethra, partial lenectomy
V	Total penectomy

Damage and trauma to the penis are most often localized in the area of the foreskin, head, cavernous bodies, and may be combined with damage to the scrotum. Damage to the male genitals mainly includes ruptures or tears of the frenulum of the penis, contusion of the penis, subcutaneous rupture of the cavernous bodies, dislocation and strangulation, scalping, cut, stab or bite wounds of the penis.

There is evidence that medical personnel treating patients with external genital injuries are more likely to become infected with hepatitis B and/or C, as 38% of such patients are carriers of the hepatitis B and/or C viruses.

[ 1 ], [ 2 ], [ 3 ], [ 4 ], [ 5 ], [ 6 ], [ 7 ]