Penile fracture: added value of novel assessment with contrast-enhanced ultrasound

Panayiotou, Andreas; Huang, Dean Y.; Makanjuola, Jonathan; Sidhu, Paul S.

doi:10.1136/bcr-2019-230864

Cited by 3 publications

(7 citation statements)

References 2 publications

(3 reference statements)

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“…On CEUS, a penile haematoma appears as a non-enhancing area, corresponding to the B-mode abnormality. CEUS allows a confident diagnosis and a better delineation of the haematoma [ 21 ]. The absence of contrast extravasation improves the operators’ confidence in excluding an underlying vascular injury [ 21 ].…”

Section: Main Textmentioning

confidence: 99%

“…CEUS allows a confident diagnosis and a better delineation of the haematoma [ 21 ]. The absence of contrast extravasation improves the operators’ confidence in excluding an underlying vascular injury [ 21 ].…”

Section: Main Textmentioning

confidence: 99%

“…Haematomas are commonly present at the fracture site, and in rare cases, a focus of active bleeding may be detected on CEUS [ 2 , 8 ]. Preoperative US can be useful for surgical planning, allowing for more conservative surgery rather than extensive exploratory intervention [ 10 , 21 ]. Ultrasound is also of great value in assessing possible complications after the surgical repair of the penile rupture [ 25 ].…”

Section: Main Textmentioning

confidence: 99%

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Utility of contrast enhanced ultrasound (CEUS) in penile trauma

Gómez-Bermejo,

Huang,

Bertolotto

et al. 2023

Insights Imaging

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Penile traumatic injuries are rare with potentially severe consequences, with clinical assessment challenging due to pain and swelling. Ultrasound is the primary imaging modality for assessing the penis. It has a high spatial resolution and rapid availability and is portable. Contrast enhanced ultrasound is an advanced ultrasound technique that adds real-time dynamic vascular imaging safely, increasing diagnostic precision and confidence, allowing for better therapeutic management of traumatic penile injuries. Contrast enhanced ultrasound helps to delineate the extent of a haematoma, distinguishing this from the herniated corpus cavernosum, detecting the point of rupture of the tunica albuginea, showing vascular abnormalities, localising a dislocated penis and determining penile viability. The integrity of the urethra may be assessed with intracavitary contrast enhanced ultrasound. Additionally, contrast enhanced ultrasound allows monitoring of the response to endovascular and surgical treatment. This review aims to detail the anatomy and pathogenesis of penile trauma, to give guidance on optimising the contrast enhanced ultrasound technique and to obtain diagnostic examinations. Illustration of the spectrum of aspects of penile trauma will be complemented with a literature review.Critical relevance statement Contrast enhanced ultrasound is a safe and efficient imaging modality that allows for highly accurate diagnoses, helping achieve more successful and conservative treatments of penile trauma complications.Key points• Ultrasound is an accurate and safe imaging test for penile trauma.• CEUS adds dynamic vascular imaging in real-time increasing diagnostic confidence.• CEUS can delineate penile haematomas, locate fractures and demonstrate vessel integrity.• CEUS potentially allows for more conservative treatment of penile trauma complications. Graphical Abstract

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Section: Main Textmentioning

confidence: 99%

Section: Main Textmentioning

confidence: 99%

Section: Main Textmentioning

confidence: 99%

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Utility of contrast enhanced ultrasound (CEUS) in penile trauma

Gómez-Bermejo,

Huang,

Bertolotto

et al. 2023

Insights Imaging

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Section: Patients Included In Statistcal Analysis (N=88)mentioning

confidence: 99%

“…Contrast-enhanced US (CEUS) is mainly used in abdominal imaging-and only one case report of CEUS in PF exists so far (15). The authors emphasize advantages like more precise surgical planning and less extensive incision (15). Another case report describes a "microbubbleenhanced retrograde ultrasound urethrogram" that confirmed injury of the urethra avoiding radiation exposure of retrograde urethrography which is a standard procedure in inconclusive cases (16).…”

Section: Patients Included In Statistcal Analysis (N=88)mentioning

confidence: 99%

Diagnostic performance of MRI and US in suspicion of penile fracture

Spiesecke¹,

Mang²,

Fischer³

et al. 2022

Transl Androl Urol

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Background: Penile fracture (PF) is defined as rupture of the tunica albuginea of the corpora cavernosa.While most authors agree that rapid surgical therapy of this rare pathology leads to the best patient outcome, the role of imaging is highly controversial in the published literature. To obtain further evidence concerning the diagnostic accuracies of magnetic resonance imaging (MRI) and ultrasound (US) in the diagnostic assessment of patients with suspected PF. Methods: We systematically reviewed MRI and US examinations performed in our institution between 2000 and 2021 and correlated imaging reports with either intraoperative finding or final clinical diagnosis. Inclusion criteria were: (I) patient age ≥18 years, (II) examination between 2000 and 2021, (III) information available on patient's history and clinical presentation, and (IV) documented final diagnosis in discharge letter. Next to diagnostic accuracy, we describe typical imaging findings such as penile hematoma, tear of the tunica albuginea including location in terms of side and shaft segment affected, and involvement of corpus spongiosum.Results: Overall, 46 of 88 included patients (54.5%) had a confirmed diagnosis of PF. A total of 69 MRI and 31 US examinations were included. Sensitivity and specificity were 91.9% (95% CI: 78.7-97.2%) and 90.6% (95% CI: 75.8-96.8%) for MRI and 71.4% (95% CI: 45.4-88.3%) and 100.0% (95% CI: 81.6-100.0%) for US, respectively. Conclusions:The results of the present study suggest that MRI is more suitable to confirm PF and identify the site of the associated tunica albuginea tear while US is a good tool for ruling out PF.

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The Management of Penile Fracture: a Review of the Literature with Special Consideration for Patients Undergoing Collagenase Clostridium Histolyticum Injection Therapy

Hughes

Natale

2021

Curr Urol Rep

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Penile fracture: added value of novel assessment with contrast-enhanced ultrasound

Cited by 3 publications

References 2 publications

Utility of contrast enhanced ultrasound (CEUS) in penile trauma

Utility of contrast enhanced ultrasound (CEUS) in penile trauma

Diagnostic performance of MRI and US in suspicion of penile fracture

The Management of Penile Fracture: a Review of the Literature with Special Consideration for Patients Undergoing Collagenase Clostridium Histolyticum Injection Therapy

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