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Penile Fracture

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Topic updated on 09/26/16 3:16pm

Snapshot
  • penile fracture28-year-old male presents to the emergency department complaining of penile pain and swelling following a fall during sexual intercourse with his wife. The patient reports the onset of pain immediately followed a popping sound. 
Introduction
  • Penile fracture is caused by a fracture of one of the tunica albuginae surrounding the corpora cavernosa 
  • Caused by blunt trauma to an erect penis
  • May involve injury of the urethra, dorsal nerves, veins and arteries
Presentation
  • History:
    • acute onset of penile pain following injury to erect penis, often during intercourse or forceful masturbation
    • patient may recall hearing a popping or cracking sound at the time of injury
  • Symptoms & Physical exam:
    • painful, flaccid penis with or without visible signs of hematoma
    • "eggplant penis"
Evaluation & Differential
  • Generally a clinical diagnosis
  • If history and physical equivocal, can perform diagnostic cavernosography or MRI
Treatment
  •  Medical emergency generally requiring surgical repair of tunica albuginea
Prognosis, Prevention, and Complications
  • Complications may include erectile dysfunction, penile deformity, urethral injury, pain during intercouse


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(M2.RL.47) A 21-year-old man presents to the emergency room in distress. He reports that during sexual intercourse, he heard a cracking sound. He immediately noticed that his penis was bruised and that he was unable to maintain an erection. Physical examination reveals a dark, bruised, distorted penis. There is scant blood at the urethral meatus. Physical exam findings are depicted in Figure A. What is the next step in management? Topic Review Topic
FIGURES: A          

1. Counsel the patient on safe sex and reassure him that his penis will heal
2. Begin the patient on azithromycin
3. Obtain a doppler ultrasound
4. Obtain a urology consult and a retrograde urethrogram
5. Obtain an MRI of the abdomen and pelvis

PREFERRED RESPONSE ▶


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