Penile fracture


Penis anatomy
The human male urethra laid open on its anterior (upper) surface.
Transverse section of the penis.
  • Tunica albuginea of one or both corpora 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 circumstantially swollen, discolored, tender, and flaccid
  • Typically occurs during intercourse with receptive partner on top
  • Cracking sound followed by pain, usually immediate detumescence, swelling, discoloration, deformity
Penile Fracture.jpg

Differential Diagnosis

Penile trauma types


  • Clinical diagnosis
  • Rule out other trauma
  • Do NOT pass foley until confirming patient can pass urine OR
  • Retrograde urethrogram may be necessary to assure urethral integrity (especially important if pt unable to urinate)
  • Urology may request corpus cavernosography, MRI, or ultrasound if the penile fracture is atypical[2]


  • Surgical exploration/repair required for most injuries if there is obvious or suspected fracture
  • Penile hematoma with no fracture can be treated as an outpatient with NSAIDs
  • Penile laceration with no fracture can be closed with 4-0 or 5-0 absorbable sutures


  • Admit, usually to OR for operative repair

See Also


  1. Wessells H et al. Penile and genital injuries. Urol Clin North Am. 2006 Feb;33(1):117-26
  2. Lee S. et al. Trauma to male genital organs: a 10-year review of 156 patients, including 118 treated by surgery. BJU Int. 2008 Jan;101(2):211-5