While erections are sometimes referred to as “boners,” the truth of the matter is that there aren't actually any bones in the human penis. Some animals do have penile bones, though. For instance, male walruses can have penis bones up to two feet in length! In fact, they are so big that they were supposedly once used as war clubs by Native Alaskans--but I digress. Returning to the human penis, you may be surprised to learn that, despite the absence of bones, it's still very much possible to “fracture” an erection. Here's what we know about "broken" penises.

Penile fracture occurs when the cavernous bodies (the columns of erectile tissue that run the length of the penis and engorge during an erection) rupture as a result of blunt force trauma. The most common type of trauma reported appears to differ across cultures [1]. For example, in Japan, most cases are attributable to masturbatory technique or accidentally rolling onto an erect penis in bed. In the Mediterranean, most cases are due to men “kneading” an erection in order to make it go away. And in the United States, the most frequent cause is forceful intercourse in which a guy misses his target, hitting his partner’s pubic bone or perineum instead.

A recent study suggests that certain intercourse positions may be riskier than others when it comes to penile fracture [2]. In a study of 90 men who had fractured their erections, the "doggystyle" position was linked to the largest percentage of fractures (41%) among those who experienced sexual trauma. This was followed by the missionary position (25.5%) and the partner-on-top (10%) positions. The severity of the fractures observed tended to be higher when they occurred during doggystyle and missionary-style sex, too.

The first case of penile fracture was reported in the medical literature in the 1920s, and since then, at least 1,600 cases have been documented [1]. On a side note, the most interesting causes of penile fracture reported in medical journals that I've ever come across include a falling brick, pleasuring oneself with a cocktail shaker, and a donkey bite. And, no, I’m not making this up.

So what happens when a penis breaks? Most patients report hearing either a popping or cracking sound not unlike “the snapping of a corn stalk” [1]. The erection quickly disappears and is usually followed by intense pain, swelling, discoloration, and potential deformity. In severe cases (like those resulting from doggystyle or missionary-style sex), the fracture may injure the urethra, which can produce more complications, including urinary difficulties.

Until recently, the primary treatments for penile fracture consisted of ice packs, anti-inflammatories, erection-inhibiting drugs, and penis splints; however. these methods tended to lead to a high rate of long-term complications, ranging from painful and angled erections to erectile dysfunction. Today, the standard of care--especially for the more severe cases--is surgical repair, which reduces the likelihood of long-term problems. However, even with surgery, research suggests that between 6-25% of patients continue to have problems with penile function, with the most common complaint being a permanent curvature of the erection [1].

To be clear, penile fractures are quite rare and the vast majority of men are unlikely to ever experience one. However, they do happen on occasion and have the potential to result in serious consequences for men's body image and sexual functioning. If penile fracture happens to you or to a partner, seek medical treatment as soon as possible because prompt surgical repair is the key to restoring normal function as quickly as possible.

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[1] Jack, G. S., Garraway, I., Reznichek, R., & Rajfer, J. (2004). Current treatment options for penile fractures. Reviews in Urology, 6, 114-120.

[2] Barros, R., Schulze, L., Ornellas, A.A., Koifman, L., & Favorito, L.A. (2017). Relationship between sexual position and severity of penile fracture. International Journal of Impotence Research, 29, 207-209.

Image Source: 123RF/mirkofotori

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