De Brek Norbert, Peyrottes Arthur, Dariane Charles, Pattou Maxime, Clerget Alexandra, Desgrandchamps François, Sabbagh Paul, Dupuis Hugo, Duffaut Louise, Duquesne Igor, Mesnard Benoît, Miquel Capucine, Lorette Martin, Delchet Ophélie, Boileau Adrien, Levy Stéphan, Bourillon Alice, Goujon Anna, Lethuillier Valentine, Faix Antoine, Mathez William, Tissot Gabrielle, De La Taille Alexandre, Mardelli Céline, Papin Grégory, Galano Arthur, Waeckel Thibaut, Bacle Charly, Schirmann Aurélie, Chauveau Élodie, Eschwege Pascal, Gardet Jefferson, De Sousa Philippe, Reichenbach Angèle, Neuville Paul, Chabenes Maxime, Fiard Gaelle, Bessede Thomas, Lebacle Cédric
Intraoperative drainage was not associated with reduced early morbidity and was associated with a longer hospital stay and more sexual pain at 1 month. Although these findings do not support the routine use of drains after penile fracture repair, our study does not exclude a potential benefit in selected complex cases. Drain use should therefore be tailored to intraoperative findings.
PURPOSE: Penile fracture is a rare urological emergency treated by surgical exploration. However, the indication for intra-operative drainage remains debated due to limited evidence. This study aimed to assess the impact of drainage on postoperative complications and symptoms after penile fracture repair.
METHODS: We performed a retrospective multicenter study including all patients with surgically confirmed corpus cavernosum fracture between 2000 and 2024 across 21 French centers. Patients were stratified according to intra-operative drain placement. The primary outcome was any early postoperative complication within 30 days (hematoma, surgical-site infection, wound dehiscence, painful edema, skin necrosis, or urinary retention). The key secondary outcome was a focused surgical-site composite (hematoma, surgical-site infection, or wound dehiscence). Hospital stay, and symptoms at 1 and 3 months were also evaluated. Multivariable logistic regression adjusted for surgical approach, urethral or bilateral injury, and surgeon experience assessed associations with complications.
RESULTS: Among 457 patients, 153 (34%) received a drain. Drain placement was associated with longer operative time and hospital stay and more frequent degloving approach. The overall postoperative complication rate was 11%. Drain placement was not significantly associated with complications (OR 1.18; 95% CI 0.59-2.29; p =0.63), whereas urethral injury was (OR 2.33; 95% CI 1.06-4.91, p = 0.03). At 1 month, 63% of patients reported at least one symptom and sexual pain was more frequent in the drain group (25% vs 18%; p = 0.04). Interpretation is limited by retrospective design and loss to follow-up.
CONCLUSION: Intraoperative drainage was not associated with reduced early morbidity and was associated with a longer hospital stay and more sexual pain at 1 month. Although these findings do not support the routine use of drains after penile fracture repair, our study does not exclude a potential benefit in selected complex cases. Drain use should therefore be tailored to intraoperative findings.