By Madeleine Castellanos, M.D.
It's called a penile fracture, but this is a misnomer because there is no bone to break. When a penis breaks, or ruptures, what happens is that the connective tissue (tunica albuginea) that surrounds the two masses of erectile tissue which form the bulk of the penis (corpus cavernosum) tears so that the blood can no longer be contained in the space that it occupies. The blood that was creating pressure inside the corpus cavernosum, and therefore an erection, then leaks out of that space to the surrounding tissues. This results in what urologists call an "eggplant deformity" which is when the penis becomes swollen and takes on a purplish color because of the blood filling the space between the tissues. The penis is also usually bending to the opposite side of the tear. If the tear is large enough, it may actually extend to the urethra, causing inability to urinate and blood to come out of the tip.
So how exactly do you break your penis? Usually, a penile fracture happens when a woman is on top and the penis comes out of her vagina, but instead of going back into her vagina with the next movement, the head gets pushed against her pubic bone, the side of her labia, or the perineum, causing an acute 'bending.' If a man has a fairly full erection at the time, the tconnective tissue cannot take the incredible amount of pressure that builds up with the "bend." A tear is then created. There are cases where the penis does not completely come out of the vagina, but the angle of return is crooked, causing it to be forced to bend as just described. In all cases, an audible "pop" or "crack" is heard as the connective tissue tears and the erection is lost.
But there are some cases of penile fracture when a man is not having sexual intercourse, but instead just masturbating or even "rearranging himself" and trying to move his erection to a different angle. If he is born with a slight flaw in a particular area of the connective tissue, that may be enough to get a tear at that spot, resulting in a fractured penis. It should be mentioned that there is a practice among some men to try to bend their penis in order to get rid of an erection. You should never try to bend your erection if it is fairly full because of the immense increase of pressure on these tissues and the risk of fracturing your penis. As you can imagine, it is an emergency and does require surgery to close up the tear in the tissues. With proper surgical attention, erectile and urinary function of the penis is restored.