Updated: 12/2/2021

Penile Fracture

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  • Snapshot
    • A 28-year-old man presents to the emergency department with penile pain after hearing a "popping" sound during sexual intercourse. On physical exam the penis is tender to palpation, s-shaped, and there is swelling and ecchymosis. Urology is immediately consulted.
  • Introduction
    • Clinical definition
      • traumatic rupture of the corpus cavernosum
        • considered a urologic emergency
  • Epidemiology
    • Incidence
      • rare
  • Etiology
    • Typically secondary to sexual intercourse
    • Pathogenesis
      • damage to the tunica albuginea occurs when the erect penis is subjected to blunt trauma or abrupt bending
  • Presentation
    • History
      • hearing a "popping" or "snapping" sound at the time of injury (often during intercourse) of the erect penis
    • Symptoms
      • pain
    • Physical exam
      • "eggplant deformity"
        • penile deformity with swelling and ecchymosis
          • abnormally curved penis ("s-shaped")
      • tenderness to palpation
  • Imaging
    • Diagnostic cavernosography
      • indication
        • when the diagnosis is equivocal
    • Magentic resonance imaging (MRI)
      • indication
        • when the diagnosis is equivocal
  • Studies
    • Diagnostic criteria
      • this is generally a clinical diagnosis based on history and physical exam
  • Differential
    • Penile amputation
    • Penetrating injury to the penis
    • Penile soft tissue injury
      • e.g., infections and burns
  • Treatment
    • Operative
      • surgical repair
        • indication
          • surgery is considered the treatment option for penile fracture
  • Complications
    • Complications
      • erectile dysfunction
      • penile deformity
      • urethral injury
      • damage to corpus cavernosum
  • Prognosis
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