Some patients with clinically diagnosed penile fracture actually have a false fracture (no tunica albuginea tear found at surgery). Although previous reports indicate that these patients often do not report hearing a snapping sound (henceforth sound) at injury, there are no studies of the sound’s role in this differential diagnosis. To assess if the sound’s absence increased the likelihood of intraoperatively diagnosing a false fracture, we retrospectively analyzed 65 consecutive clinically diagnosed penile fracture patients between January 2008 and December 2017, using surgical diagnosis of penile fracture as outcome variable and sound as main predictor, including as covariates age, presentation delay, immediate detumescence after injury, and whether injury occurred during sexual intercourse. Fifty-six patients had penile fracture (86.2%), and most (40, 71.4%) reported the sound, whereas two of the nine patients with false fracture reported the sound (22.2%, p = 0.007, Fisher’s exact test). Bayesian logistic regression revealed that the sound was associated with surgical diagnosis of penile fracture (relative odds ratio = 4.25), and the probability of penile fracture fell from 92 to 74% when the sound was not reported among patients injured during intercourse experiencing immediate detumescence. This study followed PROCESS (Preferred Reporting of Case Series in Surgery) guidelines.

一些临床诊断为阴茎骨折的患者实际上患有假性骨折（手术时未发现白膜撕裂）。尽管以前的报告表明这些患者在受伤时通常没有报告听到刺耳的声音（此后称为声音），但尚无关于声音在这种鉴别诊断中的作用的研究。为了评估声音的缺失是否会增加术中诊断假骨折的可能性，我们回顾性分析了2008年1月至2017年12月间65例临床诊断为阴茎骨折的患者，以手术诊断为阴茎骨折作为预后变量，声音作为主要预测指标，包括协变量年龄，表现延迟，受伤后立即消肿以及性交过程中是否发生过伤害。56例患者发生阴茎骨折（86.2％），p  = 0.007，Fisher精确检验）。贝叶斯逻辑回归表明，声音与阴茎骨折的手术诊断有关（相对优势比= 4.25），并且在性交过程中立即消肿的性交受伤患者中未报告声音时，阴茎骨折的可能性从92％降至74％。这项研究遵循了PROCESS（外科病例系列的首选报告）指南。