Impact of Time to Surgical Repair on Erectile Function and Clinical Outcomes Following Penile Fracture: A Retrospective Cross-Sectional Study at Two Specialist Hospitals in North-West Cameroon

Abstract

Background: Penile fracture is a urological emergency that requires prompt surgical repair to prevent functional complications. However, delayed presentation and treatment are common in sub-Saharan Africa, potentially impacting outcomes. This study aimed to evaluate the effect of time to surgical intervention on erectile function and other clinical outcomes in penile fracture cases. Methods: A retrospective cross-sectional study was conducted over a five-year period (2019-2024) at Nkwen Baptist Hospital and Regional Hospital Bamenda, Cameroon. Twenty-six patients with confirmed penile fracture who underwent surgical repair were included. Patients were categorized into early (<24 hours) and delayed (≥24 hours) surgery groups. Data on socio-demographics, clinical presentation, operative findings, and outcomes were analyzed using chi-square and t-tests. Multivariate analysis using penalized logistic regression was applied to identify independent predictors of erectile dysfunction. Results: Of the 26 patients, 15 (57.7%) underwent early surgery while 11 (42.3%) had delayed surgery. Erectile dysfunction was observed exclusively in the delayed group (45.5% vs. 0%, p = 0.0163). Time to resume sexual activity was significantly shorter in the early group (9.5 vs. 12.3 weeks, p < 0.0001). Postoperative complications were more frequent in delayed cases (45.5% vs. 0%, p = 0.0163). Multivariate analysis confirmed delayed surgery as a strong independent predictor of erectile dysfunction (adjusted OR: 10.5, 95% CI: 1.1 - 98.7). C onclusion: Early surgical repair (<24 hours) of penile fracture significantly improves erectile function and reduces complications. Timely diagnosis, prompt referral, and increased public awareness are critical for optimal outcomes in penile fracture management.