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This article is from the In-Depth Report The Science of Love

Ouch! Can You Really Break Your Penis?

The penile condition recently featured on the TV medical drama Grey's Anatomy is real and, sorry guys (and girls), not uncommon

Ever since heartthrob television doctor Mark Sloan had a sexual mishap on last night's episode of TV hit show Grey's Anatomy, bloggers  around the globe have been buzzing about a bizarre and horrifying condition called "broken penis syndrome".  For those who didn't catch last night's hot and steamy love scene between Sloan (played by actor Eric Dane) and "intern" Lexie Grey (Chyler Leigh), be advised: it ended painfully—very painfully. At least for Sloan, who suffered a severe injury to his manhood, which prompted a slew of rumors among hospital staff about which woman "broke Sloan's penis," according to ABC's online recap of the episode.

Given that there are no bones in the penis, can it really break? It turns out there is an unfortunate injury termed "penile fracture" that can indeed occur during sexual intercourse. We asked Hunter Wessells, chair of the urology department at the University of Washington School of Medicine in Seattle (also home to the show's Grace Hospital), to describe the condition and how it can happen.

[An edited transcript of the interview follows.]

What exactly is broken penis syndrome?
It's what we call penile fracture. It is a severe form of bending injury to the erect penis that occurs when a membrane called the tunica albuginea tears. The tunica albuginea surrounds the corpora cavernosa, specialized spongy tissue in the core of the penis that fills up with blood during an erection. When the tunica albuginea tears, the blood that is normally confined to this space leaks out into other tissues. You get bruising and swelling.

What are the signs of penile fracture?
Usually there will be a popping sound. If someone has severe pain (in the penis), especially associated with bruising, swelling and loss of erection, he should seek emergency care.

How exactly does penile fracture happen?
Any situation during intercourse when there is thrusting and when the penis, instead of penetrating its normal location, is hitting some solid structure (such as the perineum).  Usually this occurs during regular vaginal sex with the woman on top, but it can happen in the missionary position or during sexual acrobatics. We had this patient who suffered penile fracture after running across the room and trying to penetrate his wife with a flying leap.

What can doctors do to fix the tear?
We put the person on general anesthesia and open up the skin through one or more incisions in the penis. Then we find the edge of the tear and close it up with sutures. Sometimes these tears are extensive and span half the circumference of the penis (usually the tears are crosswise), requiring about 10 stitches. Then we close everything up. The operation takes about an hour, and most people go home right after. Most can resume sex in about a month (after the wound has healed).

What happens if you don't get this operation?
There are probably some cases in which you can get away with not operating on it but, in general, you will be more likely to have future complications. Partial or complete tearing of the tunica albuginea can lead to long-term scarring, and the buildup of scar tissue can lead to erectile dysfunction or penile deviations, such as chronic curvature of the penis (causing an erection that bends sideways—sometimes at a 45-degree angle).

How common is penile fracture, and who is most likely to suffer from it?
We don't have any incidence data like that, but we know there are many case reports in the literature. I've seen dozens of cases (in 20 years of working as a physician). At the University of Washington's Harborview Medical Center here in Seattle, we see one or two cases per month.*

Young men in their 20s and 30s, who tend to be engaged in more vigorous sexual activity face the highest risk, but we do see it in men in their 40s and 50s. (The latter's lower risk) might be because older men have decreased frequency and vigor of sexual activity and the tissue in their penises tends not to get quite as rigid.

If the penis bends but the tunica albuginea doesn't tear, could this lead to injury as well?
There are probably many men who have had the experience of missing the penetration spot and bending the penis. Most of these cases are nothing to worry about. But there are some people who have bending injuries (but not full-blown tears) who may go on to develop Peyronie's disease, a condition in which the penis is bent due to the buildup of scar tissue, but it's not yet clear whether this is the cause of the disease.

*Note (1/26/09): This sentence has been modified to correct an error.

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