Urethral pseudodiverticulum secondary to penile fracture and complete urethra dissection

Abstract

E347 research researchCite as: Can Urol Assoc J 2013;7(5-6):e347-50. http://dx.doi.org/10.5489/cuaj.1209 Published online May 13, 2013. AbstractA 22-year-old man reported cracking sound and acute pain during sexual intercourse followed by rapid penile detumescence and ecchymosis. He experienced more pain because he could not urinate and had a palpably full bladder. Moreover, his urethra was bleeding. Physical examination revealed swollen, ecchymotic and deviated penis and penis ultrasonography showed an injury of the tunica albuginea and Buck's fascia with an expanding hematoma. Suprapubic catheter was positioned. Surgical exploration revealed a tear of tunica albuginea of both corpora cavernosa and complete urethral dissection. End-to-end urethral anastomosis and suture of corpora cavernosa lesion were performed. Vescical catheter was mantained for 6 days and suprapubic catheter for 3 months to allow a complete urethral healing. A pseudodiverticulum was found at anastomosis level on the urethrocistography 1 month after surgery. It disappeared by allowing micturition via the suprapubic catheter. The patient presented regular urinary flow and physiological erections 30 days later. In our experience, prompt surgical repair preserved erectile function and keeping the suprapubic catheter protected the urethra; this was the correct management for repairing the urethral lesion.

National Patterns of Urethral Evaluation and Risk Factors for Urethral Injury in Patients With Penile Fracture

“…[1][2][3][4][5][6][7][8] Sequelae of urethral injuries in the setting of penile fracture can include urethral stricture or pseudodiverticula. 9,10 Evaluation of the urethra can be performed with a variety of techniques including cystoscopy or urethrography. Magnetic resonance imaging, which is occasionally used to confirm penile fractures, can also identify urethral injuries.…”

“…Supplementary data associated with this article can be found, in the online version, at http://dx.doi.org/ 10 …”

Urethral injury in penile fracture: a narrative review

“…This can be treated with percutaneous drainage and oral antibiotic therapy with a satisfactory outcome (8). Di Pierro et al reported a case of urethral pseudodiverticulum after urethral injury in PF and management of the case conservatively with cystostomy for two months after surgery (22).…”

“…RGU is recommended when abnormalities are found in the IPSS questionnaire or uroflowmetry to identify possible urethral stricture or other complications. ( 8 , 22 - 24 ). Short penile urethral stenosis can be treated with sequential dilatations ( 4 , 21 ).…”

Penile incerceration—A tight affair

“…These pressures are much higher than what would be considered physiological. However, this pressure can be exceeded in during sexual intercourse and penile manipulation causing rapture [6] .…”