Penile fracture: Difference between revisions
m (Rossdonaldson1 moved page Penile Fracture to Penile fracture) |
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*Unlikely to occur in blunt pelvic trauma with a flaccid penis | *Unlikely to occur in blunt pelvic trauma with a flaccid penis | ||
*Associated with a urethral injury in up to 38% of penile fractures<ref>Wessells H et al. Penile and genital injuries. Urol Clin North Am. 2006 Feb;33(1):117-26</ref> | *Associated with a urethral injury in up to 38% of penile fractures<ref>Wessells H et al. Penile and genital injuries. Urol Clin North Am. 2006 Feb;33(1):117-26</ref> | ||
==Clinical Features== | ==Clinical Features== | ||
*Penis is swollen, discolored, tender, and flaccid | *Penis is swollen, discolored, tender, and flaccid | ||
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{{Template:Penile Trauma DDX}} | {{Template:Penile Trauma DDX}} | ||
== | ==Diagnosis== | ||
*Retrograde urethrogram may be necessary to assure urethral integrity | *Retrograde urethrogram may be necessary to assure urethral integrity | ||
**Especially important if patient unable to urinate | **Especially important if patient unable to urinate | ||
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==Disposition== | ==Disposition== | ||
Admit | *Admit | ||
==See Also== | ==See Also== | ||
*[[Penile Trauma]] | *[[Penile Trauma]] | ||
== | ==References== | ||
<references/> | <references/> | ||
[[Category:GU]] | [[Category:GU]] | ||
[[Category:Trauma]] | [[Category:Trauma]] | ||
Revision as of 20:05, 21 May 2015
Background
- Tunica albuginea of one or both corpus cavernosa ruptures due to trauma to erect penis
- Can be associated with urethral rupture and deep dorsal vein injury
- Unlikely to occur in blunt pelvic trauma with a flaccid penis
- Associated with a urethral injury in up to 38% of penile fractures[1]
Clinical Features
- Penis is swollen, discolored, tender, and flaccid
- Cracking sound followed by pain, detumescence, swelling, discoloration, deformity
Differential Diagnosis
Penile trauma types
Diagnosis
- Retrograde urethrogram may be necessary to assure urethral integrity
- Especially important if patient unable to urinate
- Urology may request corpus cavernosography, MRI, or ultrasound if the penile fracture is atypical[2]
Treatment
- Surgical exploration required for most injuries if there is obvious or suspected fracture
- Hematoma evacuation and suture apposition of the disrupted tunica albuginea
- Penile Hematomas with no fracture can be treated with NSAIDs as an outpatient
- Lacerations without fractures can be closed with 5-0 or 4-0 absorbable sutures
Disposition
- Admit