Fracture With Urethral Injury: Evaluation by Retrograde Urethrogram

Abstract

Penile fracture is a rare condition. It primarily involves the rupture of the corpus cavernosum during erection, which may also affect the corpus spongiosum and urethra. We describe the case of a 35-year-old man who presented with acute penile pain, penile swelling, and a hematuria after a blunt trauma during sexual intercourse. The emergency retrograde urethrogram revealed a rare condition, extravasation of the opaque material from the penile urethra into the cavernous structure. The partial rupture of the corpus cavernosum with urethral disruption was repaired surgically. At the 3-month postoperative follow-up control, no complications were reported by the patient who has had both normal erectile and voiding functions. In cases of penile fracture with suspected urethral injury, retrograde urethrogram can be used for definitive diagnosis.Keywords: Penile fracture, urethral injury, imaging, retrograde urethrogram, magnetic resonance ÖZPenil fraktür nadir görülen bir durumdur. Penis ereksiyonu esnasında oluşan travma sonucu öncelikle korpus kavernozum rüptürü oluşur ve bu esnada korpus spongiozum ve üretra da etkilenebilir. 35 yaşında erkek hasta cinsel ilişki sırasında oluşan künt travma sonrasında akut penil ağrı, penil şişlik ve hematüri ile acil servise başvurdu. Acil retrograd üretrogram çekiminde verilen opak maddenin penil üretradan kavernoz yapılara ekstravaze olduğu (nadir görülen) izlendi. Penil üretradaki ve kavernöz yapılardaki parsiyel rüptür cerrahi olarak onarıldı. Hastanın post-operatif 3. aydaki takibinde, komplikasyonun olmadığı ve hastanın ereksiyonunun ve işeme fonksiyonunun normal olduğu gözlendi. Üretral yaralanma şüphesi olan penil fraktur olgularında retrograd üretrogram tanı koyduru cudur.

CT-guided minimally-invasive penile fracture repair

“…The underlying pathology of penile fracture is rupture of the corpus cavernosum of an erect penis (8, 9). During erection, the tunica albuginea is stretched / thinned, and if put under strain by manipulation, the firmly engorged corpus breaks through, leading to penile fracture.…”

Penile Fracture: Delayed Presentation, Primary Urethral Repair and Satisfactory Outcome

“…Penile fractures usually present with a ‘popping' sound with concomitant sudden swelling and ecchymosis of the penis followed by rapid detumescence [2]. A significant number of cases come with associated urethral injury, ranging from 3% to 38% in different literatures [8, 9]. Before now, we do not know whether delay in presentation or surgical intervention may affect the outcome of repair or risk recurrence [10].…”