Evaluation and treatment of penile fractures: accuracy of clinical diagnosis and the value of corpus cavernosography

Beysel, Melih; Tekın, Ali; Gürdal, Mesut; Yücebaş, Ergin; Şengör, Feridun

doi:10.1016/s0090-4295(02)01813-7

Cited by 54 publications

(46 citation statements)

References 20 publications

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“…However, the role of US is less clear in these patients. The following are the US findings suggestive of urethral injuries: a discontinuous penile urethra, air in the cavernosal bodies, and edema or hematoma of the corpus spongiosum, although retrograde urethrography will likely be required to confirm or exclude the diagnosis, as in our case [10,24]. However, most of our patients had surgery 3 h after presentation in the emergency unit, incurring no delay in surgery due to the prompt US investigations performed.…”

Section: Discussionmentioning

confidence: 82%

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The role of ultrasonography in the diagnosis and management of penile trauma

Dell’Atti¹

2016

J Ultrasound

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Purpose In this prospective study, we studied the role of ultrasonography (US) in the diagnosis and management of penile trauma. Methods Between 2007 and 2014, 14 patients (mean age 39 years) with suspected penile fracture underwent US examinations. Almost all patients had a history of injury during sexual intercourse or manipulation of the penis. US examinations were performed in transversal and longitudinal planes starting at the level of the glans and moving down to the base of the penis. Color-Doppler was used to identify the vascular pattern or to see any abnormal vascularity. Results The most common blunt injury to the penis that occurred in nine patients was penile fracture due to rupture of the corpus cavernosum. A tear occurred in only one of the corpora cavernosa. US showed an irregular hypoechoic or hyperechoic defect at the cavernosal rupture site. Four patients presented an injury to the subtunical venous plexus in the absence of complete tunical disruption. One patient had urethral rupture with inability to urinate and apparent urethrorrhagia. Ten patients underwent surgical operation, while four patients were observed and discharged after 2 days. Mean follow-up was 32 months (range 3-58). After 8 to 12 weeks, all of them were able to be sexually active as before. Angulations of penis persisted in one patient. Conclusion US may be the preferred imaging technique for evaluation of penile fracture before surgery. It is easy to perform, non-invasive, widely available, and inexpensive, although it requires an experienced team.Keywords Penile trauma Á Penile fracture Á Ultrasonography Á Color-Doppler sonography Á Imaging Á Tunica albuginea Riassunto Scopo In questo studio prospettico abbiamo analizzato il ruolo dell'imaging ecografico nella diagnosi e gestione del trauma penieno. Metodi Tra il 2007 ed il 2014, 14 pazienti (età media: 39 anni) con sospetto di frattura del pene furono sottoposti ad uno studio ecografico. Quasi tutti i pazienti presentavano un riscontro anamnestico di traumi avvenuti durante un rapporto sessuale o manipolazione del pene. Gli esami ecografici furono eseguiti facendo scansioni su piani trasversali e longitudinali iniziando a livello del glande e procedendo sino alla base dell'asta. L'utilizzo del ColorDoppler è stato adoperato per visualizzare l'assetto vascolare o per identificare qualsiasi forma di anomalia vascolare. Risultati La più comune forma di rottura traumatica del pene accorsa in 9 persone fu quella del corpo cavernoso. la rottura si verificò sempre a livello di un singolo corpo cavernoso. Lo studio ultrasonografico identificò il punto di rottura a livello del corpo cavernoso attraverso la visualizzazione di un irregolare stria ipoecogena o iperecogena. 4 pazienti presentarono una lesione del plesso venoso al di sotto della tunica albuginea senza rottura della stessa. Un solo paziente riportò un trauma dell'uretra presentando difficoltà alla minzione ed uretrorragia. 10 pazienti furono sottoposti ad intervento chirurgico, mentre gli altri 4 furono ricovera...

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Section: Discussionmentioning

confidence: 82%

“…The tunica albuginea is visualized as a linear hyperechoic structure covering the corpora cavernosa. The cavernosal artery is visualized on the medial portion of the corpora cavernosa [9,10]. Most patients (71 %) underwent a surgical operation using various techniques.…”

Section: Methodsmentioning

confidence: 99%

The role of ultrasonography in the diagnosis and management of penile trauma

Dell’Atti¹

2016

J Ultrasound

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“…11 False negative results have been reported with retrograde urethrography; therefore, some patients and surgeons prefer early surgery and direct inspection of urethra regardless of negative uretrography. 12,13 This is our practice. The fracture site is close to the urethral rupture and can be diagnosed and repaired easily intraoperatively.…”

Section: Discussionmentioning

confidence: 93%

Penile fracture with bilateral corporeal rupture without urethral involvement

Yonguç

Bozkurt

Ors

et al. 2014

CUAJ

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Cite as: Can Urol Assoc J 2014;8(1-2):e51-3. http://dx.doi.org/10.5489/cuaj.1226 Published online January 14, 2014. AbstractConcomitant urethral injury is rare in penile fracture. We report the case of a 34-year-old male who presented to the emergency department 12 hours after a blunt self-injury of the penis. Physical examination revealed a swollen, ecchymotic, and deviated circumcised penis without blood at the meatus. The fracture line extending along the bilateral corpora without urethral involvement was seen intraoperatively. The fracture side was repaired primarily. The patient healed and recovered without complication. To our knowledge, this is the second reported case of bilateral corporeal rupture without urethral involvement.

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“…On basis of history and physical examination alone, rate of misdiagnosis can be as high as 15%. [3,6] Differential diagnosis of penile fracture includes superficial dorsal vein rupture, deep dorsal vein rupture, dorsal penile artery avulsion, and nonspecific dartos bleeding. [4,7] Differentiating these diagnoses from penile fracture is important clinically because fractures require surgical intervention, whereas dorsal penile vessel injuries and extra-albugineal hematomas can generally be managed conservatively.…”

Section: Discussionmentioning

confidence: 99%

“…Atypical cases may occur, and in 1 study, history and physical examination were inaccurate in 15% of patients with suspected penile fracture. [3] …”

Section: Introductionmentioning

confidence: 99%