Penile fracture

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

Clinical Features

• Penis is swollen, discolored, tender, and flaccid
• Cracking sound followed by pain, detumescence, swelling, discoloration, deformity

Differential Diagnosis

Penile trauma types

• Penile amputation
• Penile contusion
• Penile fracture
• Traumatic epididymitis
• Zipper injury to penis

Work-Up

• 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

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

See Also

• Penile Trauma

Source

Tintinalli - Urogenital trauma