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Penile rupture - symptoms, causes and treatment

Penile rupture - symptoms, causes and treatment

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A penile rupture or fracture of the penis - colloquially also called penile fracture - is a tear in the erectile tissue of the penis. As a rule, this happens when the male sex breaks - be it when masturbating or during coitus. Then it cracks, hurts extremely, the limb swells and turns reddish-bluish to purple due to bruises. Such an emergency is rare with one in 175,000 new admissions to hospitals.

The most important facts

  • A penile rupture is a tear in the penile shaft.
  • The penis tear almost always arises from the fact that the limb kinks or bends unnaturally.
  • This usually happens during sexual intercourse or during masturbation.
  • Penile rupture is a medical emergency and must be treated immediately.
  • Doctors usually advise surgery. Conservative therapy takes longer, is more painful and leads to complications and permanent damage much more often.

Can the penis break?

In medical terms, the term is misleading because bones break. However, unlike some animals, the human penis does not have bones, but consists of connective tissue, ligaments and vessels. This is why experts call it a rupture of the penile erectile tissue.


The cause is an inclination, an angling and / or bending of the erect penis. This usually happens during "banal" heterosexual intercourse. Even extreme positions in lovemaking don't have to be the reason. It is more common to experience “normal” coitus, which can happen to anyone: The penis slips out of the vagina and turns on the bony pelvis of the sexual partner. Or the partner rotates with the pelvis during the penetration and turns in the process. In some cases, the woman kinks while standing while having sex and travels down the penis.
Even more rare under this anyway rare emergency are patients who rolled on their stiff penis while sleeping or tried to stuff an erect penis into tight pants.

Symptoms of a erectile tissue tear

A typical and unique selling point is a crack in the penis during tearing. At the moment of the rupture, the limb relaxes immediately. The crack is usually transverse. Now there are bruises that clearly color the penis from red to purple. The penis swells, the testicles, epididymis and spermatic cord can also enlarge. If erectile tissue beneath the urethra is affected, bleeding in the urethra is often the result. Those affected experience intense pain on the penis. The bruises often lead to a "crooked curvature" of the penis towards the intact side.

The diagnosis

If the doctor sees the penis, which is unnaturally curved to the side, swollen and discolored with a reddish blue color, the diagnosis is almost clear. However, doctors still have to distinguish whether there is a vein tear.

First, the emergency doctor conducts a patient consultation. If it turns out that the mishap happened during masturbation or during sexual intercourse, there is hardly any other option than a tear in the penis. Unfortunately, some of those affected lie here because the situation is very embarrassing.

In addition, the crack must be determined exactly. Where is he? How big is he? How bad is the damage? An ultrasound examination of the limb, an X-ray analysis of the erectile tissue and / or magnetic resonance tomography are used for this. Ultrasound clearly shows tears in the connective tissue and bruises on the scrotum and penis shaft.

X-rays are important not only to locate a clear tear in the penis, but also to identify in unclear cases whether there is such a tear in the erectile tissue.


Penile rupture is a medical emergency. You must go to the emergency doctor immediately. Both conservative therapy and surgery are possible, although surgery is almost always the better choice (except for very small cracks). If the urethra is injured, a bladder catheter ensures that the urine can flow.

Conservative therapy

Here the doctor administers antiandrogens, which prevent an erection, and sedatives for the pain. In addition, there is physical protection, cooling envelopes and compressive bandages. Antibiotics should be taken to prevent bacterial infection of the wound. Such therapy can lead to complications. The wound can become infected and when it heals, an ugly scar can form that deforms the penis. The wound heals slowly and in pain.

Penile shaft surgery

This is the common method that your doctor usually recommends. During this operation, the tears in the erectile tissue are closed. To do this, cut an access into the foreskin or penile shaft and then sew the torn tissue with resorbable threads.

After the operation, the patient is given a bandage to prevent swelling and antiandrogens such as bicalutamide and benzodiazepines that numb the pain. It is absolutely necessary: ​​no sex for a month!


As painful as a penile tear is, the prognosis after an expertly performed operation is good. The injury usually heals without problems. Late consequences of the trauma are only rare erectile problems. Conservative therapy, on the other hand, often leads to a curvature of the penis (usually viewed as unsightly) and consequential pain. Rare bruising and swelling that don't go away are rare after-effects.

Risk factors

Just as luck can be challenged, some try it with misfortune. The likelihood of a penis tear increases drastically if you masturbate with tools that constrict, kink or suck the penis shaft. Plugging the erect penis into the tube of a running vacuum cleaner, which is sometimes practiced as a test of courage among teenagers, puts those affected in great danger of suffering from a penile rupture. Positions in both vaginal and anal intercourse, in which the penis kinks or curves, are also risky.

Excuses for a penis tear

Unfortunately, a penile tear is often filled with shame for those affected. In the worst case, they delay the treatment, like a worker in the United States who only went to the doctor when his scrotum was already inflated like a balloon - the patient had masturbated on an assembly line, with the penis and scrotum getting into the machine.

These excuses are particularly bizarre in countries where open talk about sexual intercourse is taboo, such as in Iran. Here, treating doctors report of patients who stated that the cause of their penile rupture was that a donkey had bitten their limbs. Or else, a brick fell from a roof onto her penis.

So please make it absolutely clear: an injury to the penis is not embarrassing, but a wound that needs treatment. Doctors only have the task of healing their injuries and are not interested in their sexual preferences. (Dr. Utz Anhalt)

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.


  • Deutscher Verlag für Gesundheitsinformation GmbH: Penile fracture: tear in the erectile tissue (accessed: July 6, 2019), urology-guide.com
  • Amboss GmbH: Penis rupture (retrieval: 06.07.2019), amboss.com
  • Dr. med. Dirk Manski: Penile fracture: erectile tissue rupture or broken penis (accessed: July 6, 2019), urologielehrbuch.de
  • Jack, G.S. / Garraway, I. / Reznichek R. / Rajfer J .: Current treatment options for penile fractures, Reviews in Urology, 2004, ncbi.nlm.nih.gov
  • Dr Praveen Jha: Penile fracture (accessed: July 6, 2019), radiopaedia.org

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