Penile fracture with urethral injury: Our experience in a tertiary care hospital

Kasaraneni, Priyatham; Mylarappa, Prasad; Gowda, Ramesh Desi; Puvvada, Sandeep; Kasaraneni, Dheeraj

doi:10.4081/aiua.2018.4.283

Cited by 13 publications

(15 citation statements)

References 17 publications

(23 reference statements)

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“…PF and urethral injury are related, particularly in a suggestive physical examination and medical history findings such as severe urine retention and urethral bleeding. Immediate primary surgery is the safest and most efficient method for treating urethral injury and PF simultaneously [ 1 ]. The most typical cause of injury to the erect penis was sexual intercourse.…”

Section: Introductionmentioning

confidence: 99%

Penile Fracture With Urethral Bleeding: A Urological Emergency

Krishnani¹,

Anjankar²,

Kakar³

et al. 2022

Cureus

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Erection transforms the penis from a safe, flaccid organ to a susceptible one. During an erection, the thick tunica albuginea thins and becomes fracturable. Penile fracture (PF) is a very uncommon ailment produced by a blow to the erect penis. Unphysiological bending of the erect penis during sexual activity or masturbation is the most often reported mechanism of trauma. The penis is made up of three columns of erectile tissue: one ventral corpus spongiosum and two dorsolateral corpora cavernosa, each enclosed by the tunica albuginea. The tunica albuginea is a bilaminar structure composed of collagen and elastin. The outer layer of the tunica determines its strength and thickness. It varies in several locations across the shaft and is thinnest ventrally. It has high tensile strength and can sustain rupture at intra-cavernous pressures of up to 1500 mmHg. The tunica albuginea's thickness decreases from 2 mm to 0.25 mm while the penis is erect, and a trauma-induced rise in intracorporeal pressure during an erection might easily cause rupture. PF with urethral bleeding is a very rare urological emergency. One of the common causes of PF includes vigorous sexual intercourse. Symptoms include a cracking, snapping, or clicking sound followed by an instantaneous detumescence. Additionally, the penis may exhibit acute discomfort, significant ecchymosis, rapid swelling, and noticeable eggplant deformity. This is a case report of a 30-year-old male who presented with a history of penile swelling and ecchymosis during sexual intercourse. There was blood spotted at the urethral meatus. A retrograde urethrogram showed complete disruption at the proximal third of the urethra. The patient was immediately taken for surgery, and extensive exploration was done. There was a significant defect of the tunica albuginea of the corpora cavernosa on the ventral side of the penis. Along with the defect and the PF, there was a sizeable urethral injury as well. The defect of the tunica albuginea of the corpora cavernosa was repaired with a Prolene 2.0 suture (Johnson & Johnson, New Brunswick, New Jersey, United States), and urethral reconstruction was done with Vicryl 3.0 interrupted suture (Johnson & Johnson, New Brunswick, New Jersey, United States) over a 14-Foley catheter. Ultrasonography (USG) can be used to assess patients who have suffered penile injuries as well as to determine the sort of incision that is necessary, saving time by preventing needless waiting. This instance emphasises the value of early diagnosis in cases of unique presentation and early surgical treatment for improved results.

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Section: Introductionmentioning

confidence: 99%

Penile Fracture With Urethral Bleeding: A Urological Emergency

Krishnani¹,

Anjankar²,

Kakar³

et al. 2022

Cureus

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“…[ 1 2 ] Cases of urethral injury associated with penile fractures, also called as tritubular penile fracture, are rare. [ 3 4 ] We report a case of a complete urethral rupture occurring with penile fracture.…”

Section: Introductionmentioning

confidence: 99%

Penile fracture with complete urethral rupture and urine extravasation: A case report

Makama

Haruna

Yusuf

et al. 2021

J West Afr Coll Surg

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Penile fracture is a rare traumatic injury of an erect phallus involving mainly the tissues responsible for penile erection, corpora cavernosa, and penile sheath, which occur commonly, but not solely during vigorous sexual intercourse. Here, we present a 34-year-old man who presented with a 5-h history of snapping sound heard during sexual intercourse with subsequent loss of tumescence, swelling of the phallus, and assumption of abnormal contour, scrotal swelling, and lower anterior abdominal swelling. On examination, the patient was in severe painful distress with swelling around the external genitalia and lower abdomen and dorsolateral penile angulation with marked tenderness. The diagnosis of penile fracture was made; intraoperatively, there was a complete rupture of both corpora cavernosa and corpus spongiosum, complete disruption of the urethra, and buck’s fascia tear causing haematoma and urine extravasation into the scrotum and anterior abdominal wall. The patient had haematoma evacuation, corpora repair, and urethroplasty done, did well, and has been on follow-up for 2 years with good erectile and voiding functions.

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“…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.…”

Section: Introductionmentioning

confidence: 99%

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

Yunusa

Wullie

Willie

et al. 2019

Case Reports in Urology

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Penile fracture is a relatively rare condition warranting emergency intervention. The commonest etiological factor remains coital activities, which explains why it is being underreported. Presentation is usually delayed and up to 38% of cases present with associated urethral injury. Prompt surgical intervention and primary urethral repair are associated with a good outcome. We present a 30-year-old male with unilateral penile fracture and associated urethral injury following sexual intercourse.

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Penile fracture with urethral injury: Our experience in a tertiary care hospital

Cited by 13 publications

References 17 publications

Penile Fracture With Urethral Bleeding: A Urological Emergency

Penile Fracture With Urethral Bleeding: A Urological Emergency

Penile fracture with complete urethral rupture and urine extravasation: A case report

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

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