scholarly journals Penile fracture: A rare case of simultaneous rupture of the one corpus cavernosum and complete urethral rupture

2015 ◽  
Vol 72 (1) ◽  
pp. 60-62
Author(s):  
Djordje Nale ◽  
Nebojsa Bojanic ◽  
Predrag Nikic

Introduction. Penile fracture is a traumatic rupture of tunica albuginea and the tumescent corpora cavernosa due to the nonphysiological bending of the penile shaft, presenting with or without rupture of corpus spongiosum and urethra. The incidence of concomitant injury of the urethra is 0-38%. Complete urethral rupture is rare, but it is almost always associated with bilateral corporeal injury. Case report. We presented a patient with complete urethral rupture, and rupture of the right cavernous body. According to the available literature, this case is extremely rare. Conclusion. Fracture of the penis is relatively uncommon and is considered a urologic emergency. Prompt surgical exploration and repair can preserve erectile and voiding function.

2015 ◽  
Vol 87 (3) ◽  
pp. 260 ◽  
Author(s):  
Marco Garofalo ◽  
Lorenzo Bianchi ◽  
Giorgio Gentile ◽  
Marco Borghesi ◽  
Valerio Vagnoni ◽  
...  

Objective: To present the management of a patient with partial disruption of both cavernosal bodies and complete urethral rupture and to propose a non-systematic review of literature about complete urethral rupture. Material and method - Case report: A 46 years old man presented to our emergency department after a blunt injury of the penis during sexual intercourse. On physical examination there was subcutaneous hematoma extending over the proximal penile shaft with a dorsal-left sided deviation of the penis and urethral bleeding. Ultrasound investigation showed an hematoma in the ventral shaft of the penis with a discontinuity of the tunica albuginea of the right cavernosal corporum. The patient underwent immediate emergency surgery consisted on evacuation of the hematoma, reparation the partial defect of both two cavernosal bodies and end to end suture of the urethra that resulted completely disrupted. Results: The urethral catheter was removed at the 12-th postoperative day without voiding symptoms after a retrograde urethrography. 6 months postoperatively the patients was evaluated with uroflowmetry demonstrating a max flow rate of 22 ml/s and optimal functional outcomes evaluated with validated questionnaires. 8 months after surgery the patients was evaluated by dynamic magnetic resonance (MRI) of the penis showing only a little curvature on the left side of the penile shaft. Conclusion: Penile fracture is an extremely uncommon urologic injury with approximately 1331 reported cases in the literature till the years 2001. To best of our knowledge from 2001 up today, 1839 more cases have been reported, only in 159 of them anterior urethral rupture was associated and in only 22 cases a complete urethral rupture was described. In our opinion, in order to prevent long term complications, in case of clinical suspicion of penile fracture, especially if it is associated to urethral disruption, emergency surgery should be the first choice of treatment.


2016 ◽  
Vol 88 (3) ◽  
pp. 233 ◽  
Author(s):  
Zeki Bayraktar ◽  
Selami Albayrak

Although penile fracture is a rare case, it is a well-described urologic emergency. It results from the rupture of the tunica albuginea of corpora cavernosa by blunt strain that commonly mandates immediate surgical exploration. Urethral injury may also accompany penile fracture. An ideal anamnesis and a special physical examination were determinant to achieve a correct diagnosis. It is usually diagnosed based on clinical examination, but ultrasonography can be very helpful in diagnosis. The treatment is based on the presence of associated urethral injury. Early surgery is preferable to conservative management, because it is associated with better outcomes and fewer long-term complications. The surgical repair of cavernous body can produce good results, with a favorable prognosis and minimal rate of complications. We present a penile fracture case of 34-year-old with subtotal rupture of the right corpus cavernosum without urethral injury who treated by early surgery and good results.


2018 ◽  
Vol 5 (11) ◽  
pp. 3747
Author(s):  
Akhilesh Kumar Yadav ◽  
Sankalp Dwivedi ◽  
Sagar Bassi ◽  
Sunil Kumar Singh

Fracture Penis is not usual. It is a tear in the tunica albuginea of the corpora cavernosa with or without involvement of corpus spongiosum and urethra. The usual cause is abrupt bending of the erect penis by blunt trauma, most commonly during sexual intercourse. A crackling sound, pain, detumescences, bruising, swelling, and bleeding per urethra are the common symptoms reported by the patients. Early surgical management is treatment of choice. Diagnosis of Penile Fracture refers to a rupture of the corpus cavernosum induced by blunt trauma to erect penis. Mainly diagnosed clinically from their stereotypical crackling sound from the erect penis at the moment of injury, rapidly followed by acute swelling, pain and penile deformity. Treatment recommendations include immediate exploration and repair. Surgical repair requires evacuation of hematoma, identification of tear, repair of the tear and ligation of any disrupted vasculature. Long term complications after repair include penile deviation, painful intercourse, painful erection and erectile dysfunction. The diagnosis of penile fracture is mostly clinical. Based on physical examination and typical crackling sound at the time of injury. Prompt surgical exploration and repair are advocated in almost all cases. Immediate surgery reduces long term complication which is post-traumatic penile curvature.


2014 ◽  
Vol 86 (1) ◽  
pp. 39 ◽  
Author(s):  
Gabriele Antonini ◽  
Patrizio Vicini ◽  
Salvatore Sansalone ◽  
Giulio Garaffa ◽  
Antonio Vitarelli ◽  
...  

Fracture of the penis, a relatively uncommon emergency in Urology, consists in the traumatic rupture of the tunica albuginea of the corpus cavernosum. Examination and clinical history can be highly suspicious of penile fracture in the majority of cases and ultrasonography (USS) can be useful to identify the exact location of the tunical rupture, which is proximal in 2/3 of cases and therefore manageable through a penoscrotal approach. Although expensive and not readily available in the acute setting, Magnetic Resonance Imaging (MRI) may play a role in the differential diagnosis with rupture of a circumflex or dorsal vein of the penis or when the tunical rupture is not associated with tear of the overlying Buck’s fascia. This form of imaging is more sensitive than USS at identifying the presence of a tunical tear. The treatment of choice is immediate surgical repair, which allows preserving erectile function and minimizing corporeal fibrosis.


KYAMC Journal ◽  
2019 ◽  
Vol 10 (2) ◽  
pp. 122-125
Author(s):  
Ashraf Uddin Mallik ◽  
Mostafizur Rahman ◽  
Fatema Bagum ◽  
Uttam Karmaker ◽  
Baikali Ferdous ◽  
...  

Penile fracture is an uncommon urological emergency, especially in Bangladesh. The other name is traumatic rupture of the tunica albuginea and corpora cavernosa in the erect penis. It occurs when an erect penis face to buckle under the pressure of a blunt sexual trauma. Patient gives the typical history of immediate detumescence, severe pain, swelling and eggplant deformity of the penile shaft due to penile injury. Immediate surgical exploration and repair of corpora Cavernosa with tunica albugenia is the most effective treatment modality. In normal cases diagnosis is made from history, physical examination alone. In some special cases ultrasonogram, radiological images, including retrograde urethrography or cavernosography are mandatory for proper diagnosis. KYAMC Journal Vol. 10, No.-2, July 2019, Page 122-125


2021 ◽  
Vol 8 (6) ◽  
pp. 804
Author(s):  
Chimaobi G. Ofoha ◽  
Ifiok P. Umana ◽  
Adedeji G. Adewale

Background: Penile fracture is a urological emergency and requires urgent medical attention. There was a relative upsurge in 2020. Diagnosis is usually based on typical history and examination findings suggestive of penile fracture. The objective of this study was to determine the demographics, clinical presentation and management of fracture of the penis.Methods: All patients who presented at the accident and emergency in 2020 with penile fracture were studied. The patients age, time to presentation, mechanism of injury, clinical features (cracking sound, pain, immediate detumescence, penile swelling, urethral bleeding and acute urinary retention) were recorded. Intraoperative findings (location of corpora rupture, length of tear and urethral rupture) were recorded and analysed.Results: Twelve patients were studied. The mean age was 34.8 years, range (20 years to 56 years). 58.3% presented within 24 hours of trauma. The commonest mechanism of penile fracture was sexual intercourse with the woman on top position (58%). 75% of the patients heard a popping sound. All patients had pain, detumescence and penile swelling (N=12) 100%. Two patients had urethral bleeding (N=2) 16.7%, with one having associated urethral rupture (N=1) 8.3%. Two patients had acute urinary retention (16.7%). Rupture of the right corpora occurred in 50%, 8.3% had bilateral rupture of the corpora. All the patients had repair of the corporal rupture. Urethral injury was repaired primarily. Erection and voiding post-repair were satisfactory.Conclusions: Fracture of the penis is a urological emergency. Diagnosis can be made based on typical history and examination findings. Prompt surgical intervention is advised to avoid complications and erectile dysfunction.


2018 ◽  
Vol 12 (2) ◽  
pp. 111-112 ◽  
Author(s):  
Ioannis Galanakis ◽  
Konstantinos Adamos ◽  
Evangelos Spyropoulos ◽  
Stamatios Mavrikos

Penile fracture is a very rare urological emergency resulting from traumatic rupture of the tunica albuginea of one or both corpora cavernosa, usually during sexual intercourse. Immediate surgical treatment is the current standard of care with lower risks of late complications, including erectile dysfunction, penile curvature, and tunical scar formation. We, hereby, report an over delayed presentation (23 days) of a penile fracture, which was successfully managed surgically. Our case emphasizes on the fact that there are not any “lost” cases and surgical treatment should always be offered to penile fracture, independently of delayed presentation.


2018 ◽  
Vol 38 (11) ◽  
pp. 2159-2165 ◽  
Author(s):  
Bruno Cesar Schimming ◽  
Gustavo N. Moraes

ABSTRACT: The penis represents the organ of the male’s copulation. It is essential to know the reproductive biology and the morphology of the reproductive organs to increase animal production. In order to contribute to this knowledge and provides information on the ram reproductive morphology, the purpose of this work was to describe the distribution, based on light microscopy, of the collagen and elastic fibers in the ram penis. For that, were collected transverse fragments of the penis (root, sigmoid flexure, body and glans) of seven rams. The specimens were fixed in paraformaldehyde for 24h and destined for the histological routine. The extracellular matrix of the ram penis was composed of collagen and elastic fibers. The penis was enveloped by the tunica albuginea, consisting essentially of collagen fibers, which were arranged in two layers: an outer longitudinal and an inner circular. This tunic emitted septa that penetrated the corpus cavernosum. The elastic fibers appeared transversely and longitudinally in the corpus cavernosum, corpus spongiosum, and next to the neurovascular bundle of the penis. This structure was not different to that reported for other domestic ruminants such as cattle and buffaloes.


2017 ◽  
Vol 19 (12) ◽  
pp. 1261-1266 ◽  
Author(s):  
Nathalia CS Borges ◽  
Marco A Pereira-Sampaio ◽  
Vivian Alves Pereira ◽  
Marcelo Abidu-Figueiredo ◽  
Maurício Alves Chagas

Objectives This study was undertaken to verify the possible modifications caused by hormonal deprivation in the extracellular matrix in the penises of neutered cats. Methods Twenty-seven penises from domestic shorthair cats were collected: 14 samples from intact cats and 13 from neutered cats. Sections were stained with Weigert’s resorcin-fuchsin, hematoxylin and eosin, and picrosirius red. Histomorphometric analysis was performed using light microscopy and image analysis software. The following parameters were analyzed: density of the elastic fibers and collagen fibers in the corpus spongiosum; density of the elastic fibers in the tunica albuginea of the corpus cavernosum and the tunica albuginea of the corpus spongiosum; luminal area of the urethra; area of the corpus spongiosum; area of the corpus cavernosum; and thickness of the urethral epithelium. The data were analyzed using the Shapiro–Wilk test to verify the normal distribution, and groups were compared using Student’s t-test; P <0.05 indicated statistically significant differences. Results Significant differences were observed between intact cats and neutered cats in the density of elastic fibers in the tunica albuginea of the corpus cavernosum (8.13% ± 1.38% vs 3.11% ± 0.66%), tunica albuginea of the corpus spongiosum (4.37% ± 1.08% vs 3.30% ± 1.01%) and corpus spongiosum (6.28% ± 3.03% vs 4.10% ± 2.19%), and density of collagen fibers in the corpus spongiosum (34.11% ± 10.86% vs 44.21% ± 12.72%). Conclusions and relevance The results show a significant decrease in the density of the elastic fibers and a significant increase of the density of the collagen fibers in the corpus spongiosum in neutered animals. This suggests that the compliance of the periurethral region is reduced, and these changes could be a predisposing factor for urethral obstructive disease.


2013 ◽  
Vol 33 (suppl 1) ◽  
pp. 107-112 ◽  
Author(s):  
Ilma C.A. Ribeiro ◽  
Marcelo Abidu-Figueiredo ◽  
Fabíola B. Costa ◽  
Marco A. Pereira-Sampaio ◽  
Maurício A. Chagas

Samples of ten penises of Mediterranean buffaloes and ten penises of Red Sindhi cattle were used. The thickness of the tunica albuginea (TA), distribution of smooth muscle cells (SMC) and volume density (Vv) of elastic system fibers in TA, corpus cavernosum (CC) and corpus spongiosum (CS) were evaluated. The Vv of elastic system fibers in buffalo and bovine penis was respectively 4.07% ±0.88% and 3.36% ±1.21% in TA; 17.32% ±2.21% and 13.14% ±1.27% (CC), 26.58% ±4.31% and 31.36% ±3.67% (CS). The CC of buffalo presented higher Vv of elastic fibers than bovine, while in the CS the Vv of elastic fibers in buffaloes was smaller than in cattle. The TA thickness showed a significant difference among the species studied. The arrangement of SMC in the bovine penises and in the water buffalo suggests that this pattern is common to animals that have fibroelastic penises.


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