Penile fracture: diagnosis and management

Isolated Penile Fracture and Complete Urethral Injury After a Motorcycle Accident: A Case Report and Literature Review

Tri-tubular penile fracture (PF) is a rare urological subdivision of PFs commonly caused by a blow to the erect penis during sexual intercourse or aggressive manipulation. PF associated with complete urethral injury and bleeding is an extremely rare presentation. This is a case report of a healthy 20-year-old male who presented to the emergency room after a motorcycle accident, experiencing rapid penile swelling and urethral bleeding. The accident happened while he was riding his motorcycle with a full erection. The patient reported a tearing sensation, immediate detumescence, and excruciating penile pain. A clinical diagnosis of PF was made, and the patient was immediately taken to the operating room for surgical intervention. At the three-month follow-up, the patient reported satisfactory erections and good voiding function. This case highlights the importance of immediate surgical intervention and urethral evaluation to avoid PF complications.

Surgical and conservative treatment results of penile fracture: single-center experience

Amaç: Bu çalışmada penil fraktürde cerrahi tedavinin komplikasyon olarak daha avantajlı olduğu ancak cerrahi sonrasında da özellikle ikinci kez cerrahi gerektirecek kadar ciddi komplikasyonların görülebileceğini göstermek amaçlandı. Gereç ve Yöntem: 05.04.2019 ve 28.07.2021 tarihleri arasında penil fraktür tanısı konulan 31 hastanın verileri retrospektif olarak değerlendirildi. 3 hasta verilerine ulaşılamaması nedeni ile dışlandı. Penil fraktür onarımı yapılan 21 hasta grup 1 ve cerrahi istemediğinden konservatif olarak izlenen 7 hasta grup 2 olarak iki gruba ayrıldı. Penil fraktür nedenleri, acil servise başvuru süreleri, ultrasonografik (USG) görüntülemeleri incelendi. Tüm hastalar cerrahi veya konservatif tedavinin altıncı ayında IIEF-15 formu ile değerlendirildi. Ayrıca operasyondan sonra penil nodül ve kurvatür, ağrılı ereksiyon açısından değerlendirildi. Bulgular: Grup 1 için median yaş 43±14,52 Grup 2 için 47±14,71 idi. Grup 1 hastalar için tunika defekti 7,02±3,26, grup 2 için 6,85±4,98 idi. İki grup arasında komplikasyon ve erektil disfonkisyon (ED) varlığı karşılaştırıldığında Grup 2 de anlamlı olarak daha fazla komplikasyon geliştiği ve daha fazla ED’ ye neden olduğu saptandı. Sonuç: Penil fraktürün komplikasyon olarak daha az olan tedavisi cerrahi tedavidir ancak cerrahi tedavinin de ikinci kez cerrahi müdahale gerektirecek komplikasyonlara neden olabileceği unutulmamalıdır.

Longitudinal Rupture of Distal Corpus Cavernosum With Concomitant Urethral Injury: An Uncommon Result of a Common Mechanism

Fracture of the penis is a well-recognized yet relatively uncommon urologic event. Forceful, blunt trauma with lateral bending of the penis in an erect state typically results in a transverse rupture of the tunica albuginea of the corpus cavernosum. Longitudinal tears of the corpus cavernosum are by themselves considered infrequent. We present a rare case of a patient with longitudinal rupture of the distal corpus cavernosum with concomitant extension to the corpus spongiosum causing partial urethral disruption as a result of trauma during sexual intercourse.

Penile fracture seems more likely during sex under stressful situations

INTRODUCTION

The unusual event of penile fracture occurs when there is a disruption of the tunica albuginea surrounding engorged erectile tissue during aggressive sexual behavior. There is often an audible crack and rapid detumescence with subcutaneous hemorrhage that follows.

AIMS

Medical literature has described the etiology and treatment of penile fracture. We report the remarkably unusual social situations of a series of patients who sustained this unique injury.

METHODS

We conducted a retrospective chart review of 16 patients whose injury was severe enough to require surgical repair at the University of Maryland between 2007 and 2011. Particular attention was paid to the intake interview in the emergency department and the postoperative chart notes by the attending urologist to ascertain out-of-the-ordinary social situations in which the injury was sustained.

MAIN OUTCOME MEASURES

The occurrence of penile fracture is sufficiently rare that the author was able to interact personally with most of the patients. The patients were remarkably forthcoming with the personal social dynamics of the sexual encounter.

RESULTS

Half of these penile fracture patients sustained the injury during an extramarital affair. Only three patients sustained the injury in a bedroom; the remainder was in out-of-the-ordinary locations for sexual intercourse, e.g., cars, elevator, the workplace, and public restrooms.

CONCLUSIONS

Penile fracture patients appear to be a unique population of men who are having sexual intercourse under stressful situations. Extramarital affairs and out-of-the-ordinary locations appear common in patients sustaining this relatively rare injury.

Penile fracture with associated urethral rupture

Penile fracture of the erect penis is an uncommon but emergent urological trauma. Potential outcomes include erectile dysfunction, penile curvature, and urethral injury. Treatment is emergent surgical repair. We present the case of a 42-year-old man with a penile fracture complicated by a urethral rupture and subsequent repair. A discussion of the key aspects of this condition is presented.