Rupture of the corpora cavernosa is observed almost exclusively in an erect penis and is caused by a forced curvature of the penis's axis resulting in intracavernous overpressure [4].

The microarchitecture of the penis is made up of transverse collagen fibers and longitudinally aligned elastic fibers. The collagen fibers prevent excessive expansion of the penis during erection and allow for a return to its original shape. Resting position during detumescence. The tunica albuginea the corpora cavernosa measure 2 mm in thickness when the penis is at rest, but thins to 0.25 mm during of the erection where it becomes more vulnerable to sudden mechanical stresses. The tunica albuginea ruptures above of 1500 mmHg pressure. Urethral rupture is the main associated injury to look for. It is commonly observed in cases of bilateral fracture of the corpora cavernosa and/or provoked fracture. Through intercourse due to the greater violence of the trauma [5,6].

Rupture of the tunica albuginea of ​​the corpora cavernosa of the penis must be surgically repaired as soon as the diagnosis is made. Antibiotic prophylaxis with second-generation cephalosporins is most often administered at the time of induction, but this varies among surgical teams. Placement of a urinary catheter facilitates identification of the urethra during the procedure [7].

For the first route This is the purpose of preoperative radiological examinations (ultrasound, MRI or cavernography), which aim to locate the fracture of the corpora cavernosa of the penis as precisely as possible, thus allowing an elective approach to the lesion. Several approaches are possible. Coronal incision at the level of the balanopreputial sulcus with degloving The complete penis has the advantage of allowing a wide access to the corpora cavernosa and the corpus spongiosum but exposes you to complications such as infection, edema and skin necrosis, the frequency of which varies from 14 to 25% [8]. For Albany, a proponent of the elective approach, the coronal incision is unnecessary and traumatic because in the vast majority of cases the tear in the tunica albuginea is located at the proximal part of the penis. Furthermore, according to the same author, this incision risks damaging subcutaneous nerve branches, which could subsequently lead to sensory disturbances in the penis. It is important to inform the patient before the procedure that, in the case of a coronal incision, a circumcision will often be performed [8].

According to Fergagny, if there is an associated urethral rupture, the foreskin should be preserved as it can be used later for a possible urethroplasty. A lateral and longitudinal incision opposite one of the corpora cavernosa allows for selective access to the fracture site without risk of skin damage. For us, this is the standard incision, to be performed whenever possible, particularly when imaging studies have clearly identified the location of the fracture. The penis is then degloved. This approach is also possible. Finally, the high penoscrotal incision, which is more aesthetically pleasing, can be used for proximal fractures. It has several advantages: it avoids undressing, which is dangerous and too extensive for a lesion that is most often at the base, it allows you to approach the lateral faces, even the dorsal surface of the corpora cavernosa [9].

Late sequelae include curvature during erection resulting from plaques secondary to the injury to the corpus cavernosum, erectile dysfunction following fibrosis of the erectile tissue and nerve and/or vascular damage; and finally, difficulty urinating due to urethral stricture, which may result from a urethral injury. Furthermore, the psychological impact of the trauma and its impact on sexual desire and erectile function have been very little studied. Erectile dysfunction may be of psychological origin and not only organic. Indeed, it has been reported that a penile fracture could affect self-esteem and a patient's self-image, leading to anxiety or depression during short-term follow-up [10,11].

This psychological impact can have repercussions for the partner. Memories trauma and the fear of experiencing another one can be encounters can lead to performance anxiety and decreased desire, even resulting in avoidance sexual.Few studies in the literature have focused on investigating predictive factors for the occurrence of erectile dysfunction after Penile fracture surgery. Age has been implicated as a risk factor for the development of erectile dysfunction after this surgery; however, the results are controversial. According to Bozzini et al., this criterion did not have a significant impact on the development of postoperative erectile dysfunction after multivariate analysis [12,13].

It has been demonstrated in some studies that the time elapsed between trauma and surgery for a fracture of the corpora cavernosa significantly affects postoperative anatomical and functional outcomes in the medium and long term; in particular, the occurrence of erectile dysfunction, painful erections, and penile curvature. Through a large study, Bozzini et al. Studies have shown that a repair delay exceeding 8.23 ​​hours is a predictive factor for the occurrence of erectile dysfunction. Similarly, Naouar et al. showed that patients operated on beyond the first 24 hours had a higher risk of complications such as penile curvature and painful penetration (p = 0.001 and 0.0001, respectively). Other studies have not demonstrated an impact of the time elapsed since surgery on the occurrence of erectile dysfunction [14-18].