Long-term outcomes comparison of immediate and delayed surgical intervention for penile fracture: A systematic review and meta-analysis

Introduction and objectives. - Penile fracture is a rare urological trauma that needs immediate repair. However, several reports stated that a delayed surgical repair might be acceptable. Thus, we aim to evaluate the long-term outcomes of immediate and delayed surgical intervention for penile fracture treatment.Materials and methods. - We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines to perform this meta-analysis. A comprehensive search through PubMed, Scopus, and Science-direct was performed using Medical Subject Head-ings (MeSH (R)) Terms. The primary outcome analyzed in this study was long-term complications, including erectile dysfunction (ED), penile curvature, penile pain, and palpable plaque. The publication bias was assessed using funnel plot and Harbord's test. All analyses were per-formed using STATA (R) 16 and the protocol for the meta-analysis has been registered in PROSPERO (CRD42022315154).Results. - A total of 10 studies were included in the analysis, comprising 2 prospective studies, 5 retrospective studies, and 3 case series, for a total of 531 patients with penile fractures. From the pooled analysis, lower ED incidence in the immediate surgical repair group was significant on less than 12 months follow-up (OR: 0.36, 95% CI: 0.15 to 0.89, P = 0.03). However, this difference was not significant on longer follow-up (OR: 1.39, 95% CI: 0.29 to 6.58, P = 0.68). No significant difference was found in the incidence of palpable plaque (OR: 0.74, 95% CI: 0.26 to 2.12, P = 0.57). Additionally, penile pain/paresthesia (OR: 0.17, 95% CI: 0.06 to 0.51, P < 0.01) and penile curvature incidence (OR: 0.17, 95% CI: 0.06 to 0.47, P < 0.01) was also significantly lower in the immediate repair group than the delayed approach group. The funnel plot analysis and Harbord's test did not suggest any publication bias (P = 0.804). Conclusion. - Immediate surgical intervention remains the best option for penile fracture treat-ment due to reduced risk of long-term complications, including penile pain and penile curvature.(c) 2022 Sexologies. Published by Elsevier Masson SAS. All rights reserved.

Automated summary

Immediate surgical intervention is the best option for penile fracture treatment as it reduces the risk of long-term complications, including penile pain and penile curvature.