Proximal Corpus Cavernosum Tear Presenting as Scrotal Hematoma

Abstract

We present the case of a penile fracture involving the proximal corpus cavernosum, presenting as a hematoma extending into the scrotum. The presentation, diagnosis, and surgical approach, which differ from the more typical penile shaft fracture, are delineated.

A rare case of traumatic proximal corpus cavernosal fracture that presented only with perineal haematoma

“…A MEDLINE literature search using the keywords 'penile fracture' and 'proximal cavernosal tear' revealed only two similar cases, the first one dated in 2000. 2,3 In the previous cases reported in the literature, the presentation was more insidious, while our patient presented acutely. For distal or penile shaft fractures, surgical intervention with closure of the tunica albuginea is advised, as it ensures the lowest rate of negative longterm complications.…”

“…A MEDLINE literature search using the keywords ‘penile fracture’ and ‘proximal cavernosal tear’ revealed only two similar cases, the first one dated in 2000. 2,3…”

A case report of a proximal corporal cavernosa injury presenting with butterfly perineal ecchymosis

“…To date, there appears to be only two other case reports of proximal corporal cavernosa injury requiring a perineal approach. 2 , 3 Pruthi et al reports the insidious onset of “butterfly” perineal ecchymosis whereas Darves-Borno et al reported an acute presentation of scrotal hematoma. These presentations along with the case reported, notably have an absence of the “eggplant” deformity.…”

The pelvic pop

“… 4 More recently in 2013, Darves-Bornoz et al . 5 described a case of internal penile fracture in a 47-year-old patient who presented with scrotal pain and swelling 1 week after painful intercourse. Given his delayed presentation, the patient underwent a penile MRI which demonstrated a tear in the extreme proximal right corpus cavernosum.…”

“…This fracture was also repaired through a midline perineal incision. 5 In both cases, perineal approaches were selected due to surgeon familiarity and the belief that adequate surgical exposure could only be obtained via the perineum.…”