Isolated corpus spongiosum injury after sexual intercourse

Abstract

Penile fractures are generally rare and underreported. The mechanism of injury is due to a rupture of the corpora cavernosa following blunt or sexual trauma to the penis when fully erect. Penile fractures usually present with a ‘popping’ sound with concomitant sudden swelling and ecchymosis of the penis followed by rapid detumescence. Urethral involvement occurs only in a small part of the cases. Isolated spongiosal injury after sexual intercourse is also extremely rare. The cardinal sign of urethral injury is blood at the meatus. A small laceration can be repaired by simple closure with absorbable sutures, while a complete rupture requires a more complex anastomotic repair. We report a case of a typically presenting penile fracture that was eventually proven to be an isolated corpus spongiosum injury, with no corpora cavernosa involvement.

Urethral bleeding following sexual intercourse: penile fracture versus anterior urethral injury

“…Isolated penile urethral injury following coital trauma is uncommon. Few cases have been reported whereby despite typical presentations suggestive of penile fracture, subsequent exploration demonstrated no defects in the tunica albuginea over the corpus cavernosa 6–8 . Blood at the meatus, haematuria or acute urinary retention following coital trauma is highly suggestive of urethral injury and necessitates further evaluation.…”

“…Few cases have been reported whereby despite typical presentations suggestive of penile fracture, subsequent exploration demonstrated no defects in the tunica albuginea over the corpus cavernosa. [6][7][8] Blood at the meatus, haematuria or acute urinary retention following coital trauma is highly suggestive of urethral injury and necessitates further evaluation. Retrograde urethrography and urethroscopy have been proposed as the gold standard diagnostic modalities.…”

“…Retrograde urethrography and urethroscopy have been proposed as the gold standard diagnostic modalities. 7,8 The injury is hypothesized to occur due to ventral force on the penis, stretching it dorsally to tear the spongiosum and urethra but leaving the cavernosum intact. 7 These cases highlight the importance of having a high index of suspicion for penile fracture for men with urethral bleeding following sexual intercourse, regardless of external physical examination findings.…”

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

“…Penile fracture is defined as the rupture of the tunica albuginea of the corpus cavernosum caused by blunt trauma to the erect penis [1]. The condition is relatively rare and under reported [2], but its occurrence requires emergency intervention. There are several etiological factors, but blunt trauma from coitus accounts for most causes [3].…”

“…Others include falls, forceful manipulation or masturbation [4, 5] or rolling over an erect penis [6], and Penile curvature (chordae) [7]. 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].…”