National Patterns of Urethral Evaluation and Risk Factors for Urethral Injury in Patients with Penile Fracture

Joseph J Pariser, Shane M. Pearce, Sanjay G. Patel, Gregory T. Bales

Research output: Contribution to journalArticle

12 Scopus citations

Abstract

Objective To examine the epidemiology and timing of penile fracture, patterns of urethral evaluation, and risk factors for concomitant urethral injury. Materials and Methods The National Inpatient Sample (2003-2011) was used to identify patients with penile fractures. Clinical data included age, race, comorbidity, insurance, hospital factors, timing, hematuria, and urinary symptoms. Rates of formal urethral evaluation (cystoscopy or urethrogram) and urethral injury were calculated. Multivariate logistic regression was used to identify predictors of urethral evaluation and risk factors for urethral injury. Results A weighted population of 3883 patients with penile fracture was identified. Presentations during weekends (37%) and summers (30%) were overrepresented (both P <.001). Urethral evaluation was performed in 882 patients (23%). Urethral injury was diagnosed in 813 patients (21%) with penile fracture. There was an increased odds of urethral evaluation with hematuria (odds ratio [OR] = 2.99; 95% confidence interval [CI], 1.03-8.73; P =.045) and a decrease for Hispanics (OR = 0.42; 95% CI, 0.22-0.82; P =.011). Older age (32-41 years: OR = 1.84; 95% CI, 1.07-3.16; P =.027; >41 years: OR = 2.25; 95% CI, 1.25-4.05; P =.007), black race (OR = 1.93; 95% CI, 1.12-3.34; P =.018), and hematuria (OR = 17.03; 95% CI, 3.20-90.54; P =.001) were independent risk factors for urethral injury. Conclusion Penile fractures, which occur disproportionately during summer and weekends, were associated with a 21% risk of urethral injury. Urethral evaluations were performed in a minority of patients. Even in patients with hematuria, 55% of patients underwent formal urethral evaluation. On multivariate analysis of patients with penile fracture, hematuria as well as older age and black race were independently associated with concomitant urethral injury.

Original languageEnglish (US)
Pages (from-to)181-186
Number of pages6
JournalUrology
Volume86
Issue number1
DOIs
StatePublished - Jul 1 2015
Externally publishedYes

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