Presentation Authors: Dayron Rodriguez, Kai Li*, Michel Apoj, Boston, MA, Nannan Thirumavalavan, Houston, TX, Ricardo Munarriz, Boston, MA
Introduction: The epidemiology of penile fractures in the emergency setting is not well described. Aim of this study is to examine the incidence, evaluation, management and use of financial resources in patients presenting with penile fractures to the emergency departments (ED) nationwide in the Unites States.
Methods: Emergency department visits with a primary diagnosis of penile fractures (ICD-9 codes) between 2010 and 2014 were abstracted from the Nationwide Emergency Department Sample (NEDS).
Results: This retrospective population based 5-year study documents a weighted estimate of 8,135 visits to the ED for penile fracture in the United States, which represents a national incidence of 1.02 per 100,000 male subjects per year (+/- 0.068 SE). No meaningful trends in incidence were observed over the study period. The incidence of penile fractures was more common during the summer months (P < 0.01) and weekends (p < 0.01; table 1). Urethral injury was diagnosed in 8.05% of patients with penile fractures. In patients with penile fractures, 60% were treated non-surgically or discharged from the ED, 28.1% underwent surgical repair, and 10.4% were transferred to other institutions. Factors leading to patient transfers included non-academic, rural and non-trauma hospitals, low economic income and low emergency department volume. In addition, weekend and spring presentation were associated with higher transfer rates.
Conclusions: This large retrospective population-based study of penile fractures demonstrates a low incidence of penile fractures presenting to the US emergency departments. Penile fractures occur more frequently during weekends and summer months. A quarter of patients undergo immediate surgical repair, 10% are transferred to other institutions and over 60% of patients are discharged home. Factors leading to patient transfers included non-academic, rural and non-trauma hospitals, low economic income and low emergency department volume. High ED discharges, low immediate surgical repair rates and high transfer rates may be due to health care disparities.