Penile fracture may be caused by crush injury to an erect penis (usually from the woman-on-top position). It is a surgical emergency requiring surgery to evacuate the hematoma and to mend the torn tunica albuginea. If urethral trauma is expected, a urethrogram if a useful initial step in management in addition to a urology consult.
Although less frequently injured than other parts of the body, the penis can be wounded in many other types of trauma including automobile accidents, gunshot wounds, or burns. However, the most common etiology is trauma during sexual activity.
Figure A depicts the "Eggplant Deformity" of the penis.
Answer 1: Reassurance would be inappropriate in this case since it is a surgical emergency.
Answer 2: Azithromycin can be used for chlamydia infection but will not have an impact on penile fracture as it is a surgical emergency.
Answer 3: Doppler ultrasound plays a role in diagnosis of testicular torsion but not in penile trauma.
Answer 5: An MRI of the abdomen and pelvis is an expensive test and would take too long to perform with this surgical emergency.