scholarly journals Urethral pseudodiverticulum secondary to penile fracture and complete urethra dissection

2013 ◽  
Vol 7 (5-6) ◽  
pp. 347 ◽  
Author(s):  
Giovanni B. Di Pierro ◽  
Luca Iannotta ◽  
Michele Innocenzi ◽  
Caterina Gulia ◽  
Vincenzo Gentile ◽  
...  
Keyword(s):  
Physical Examination ◽  
Surgical Repair ◽  
Tunica Albuginea ◽  
Urinary Flow ◽  
Suprapubic Catheter ◽  
Penile Fracture ◽  
Surgical Exploration ◽  
Corpora Cavernosa ◽  
Full Bladder ◽  
Urethral Lesion

A 22-year-old man reported cracking sound and acute pain during sexual intercourse followed by rapid penile detumescence and ecchymosis. He experienced more pain because he could not urinate and had a palpably full bladder. Moreover, his urethra was bleeding. Physical examination revealed swollen, ecchymotic and deviated penis and penis ultrasonography showed an injury of the tunica albuginea and Buck’s fascia with an expanding hematoma. Suprapubic catheter was positioned. Surgical exploration revealed a tear of tunica albuginea of both corpora cavernosa and complete urethral dissection. End-to-end urethral anastomosis and suture of corpora cavernosa lesion were performed. Vescical catheter was mantained for 6 days and suprapubic catheter for 3 months to allow a complete urethral healing. A pseudo diverticulum was found atanastomosis level on the urethrocistography 1 month after surgery. It disappeared by allowing micturition via the suprapubic catheter. The patient presented regular urinary flow and physiological erections 30 days later. In our experience, prompt surgical repair preserved erectile function and keeping the suprapubic catheter protected the urethra; this was the correct management for repairing the urethral lesion.

scholarly journals Case Report: Double penile fracture

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 1828
Author(s):  
Felipe Mercado-Olivares ◽  
J. Antonio Grandez-Urbina ◽  
Giomar Farfan-Daza ◽  
Juan Pacheco-Sauñe ◽  
Luciano Nuñez-Bragayrac
Keyword(s):  
Tunica Albuginea ◽  
Young Male ◽  
Successful Outcome ◽  
Urethral Injury ◽  
Penile Shaft ◽  
Post Injury ◽  
Penile Fracture ◽  
Surgical Exploration ◽  
The Third ◽  
Corpora Cavernosa

Penile fracture is an underreported surgical emergency. It usually occurs as a single rupture of the tunica albuginea in one of two corpora cavernosa; a rupture of both masses is an uncommon finding. We report a case of a young male who presented to the emergency department two hours after sustaining penile trauma. Prompt surgical exploration was performed four hours post-injury. He was found to have one fracture on each corpora cavernosa, without urethral injury, which were repaired successfully. The patient had a favorable recovery and was discharged on the third postoperative day without complications. The aim of this report is to highlight the importance of complete degloving of the penile shaft for a meticulous search during surgery to avoid missed injuries. This approach will ensure a successful outcome avoiding physical and psychological disabilities.

scholarly journals Penile fracture with bilateral corporeal rupture and complete urethral disruption: case report and literature review

2013 ◽  
Vol 5 (2) ◽  
pp. 23
Author(s):  
Nathan A. Hoag ◽  
Kiara Hennessey ◽  
Alan So
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Erectile Function ◽  
Surgical Repair ◽  
Review Of The Literature ◽  
Penile Fracture ◽  
Rare Injury ◽  
Surgical Exploration ◽  
Corpora Cavernosa

Penile fracture is a rare injury most commonly sustained duringsexual intercourse. We report the case of a 35-year-old man whopresented with bilateral rupture of the corpora cavernosa andcomplete disruption of the urethra. A review of the literature onpenile fracture is also presented. Urgent surgical exploration wasperformed and the injuries repaired primarily. In follow-up, thepatient reported satisfactory erectile function. This case highlightsthe importance of early surgical repair and evaluation for concomitanturethral injuries in cases of penile fracture.

scholarly journals Case Report: Double penile fracture

F1000Research ◽  
2019 ◽  
Vol 7 ◽  
pp. 1828
Author(s):  
Felipe Mercado-Olivares ◽  
J. Antonio Grandez-Urbina ◽  
Giomar Farfan-Daza ◽  
Juan Pacheco-Sauñe ◽  
Luciano Nuñez-Bragayrac
Keyword(s):  
Tunica Albuginea ◽  
Young Male ◽  
Successful Outcome ◽  
Urethral Injury ◽  
Penile Shaft ◽  
Post Injury ◽  
Penile Fracture ◽  
Surgical Exploration ◽  
The Third ◽  
Corpora Cavernosa

Penile fracture is an underreported surgical emergency. It usually occurs as a single rupture of the tunica albuginea in one of two corpora cavernosa; a rupture of both masses is an uncommon finding. We report a case of a young male who presented to the emergency department two hours after sustaining penile trauma. Prompt surgical exploration was performed four hours post-injury. He was found to have one fracture on each corpora cavernosa, without urethral injury, which were repaired successfully. The patient had a favorable recovery and was discharged on the third postoperative day without complications. The aim of this report is to highlight the importance of complete degloving of the penile shaft for a meticulous search during surgery to avoid missed injuries. This approach will ensure a successful outcome avoiding physical and psychological disabilities.

Penile Fracture-Report of Two Cases and Review of Current Literature

KYAMC Journal ◽  
2019 ◽  
Vol 10 (2) ◽  
pp. 122-125
Author(s):  
Ashraf Uddin Mallik ◽  
Mostafizur Rahman ◽  
Fatema Bagum ◽  
Uttam Karmaker ◽  
Baikali Ferdous ◽  
...  
Keyword(s):  
Tunica Albuginea ◽  
Traumatic Rupture ◽  
Penile Fracture ◽  
Corpora Cavernosa ◽  
Effective Treatment Modality ◽  
Special Cases ◽  
History Of ◽  
Penile Injury ◽  
Urological Emergency ◽  
Erect Penis

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

scholarly journals Penile Fracture: Simultaneous Complete Urethral Rupture with Bilateral Corpora Cavernosa Rupture

2018 ◽  
Vol 2018 ◽  
pp. 1-3 ◽  
Author(s):  
Ibrahim Alnadhari ◽  
Osama Abdelhaleem Abdeljaleel ◽  
Venkata Ramana Pai Sampige ◽  
Ausama Abdulmuhsin ◽  
Ahmad Shamsodini
Keyword(s):  
Blunt Trauma ◽  
Sexual Intercourse ◽  
Rare Case ◽  
Urethral Injury ◽  
Penile Fracture ◽  
Surgical Exploration ◽  
Corpora Cavernosa ◽  
Retrograde Urethrogram ◽  
Proximal Urethra ◽  
Urethral Rupture

Penile fracture is not uncommon blunt trauma to the penis. Here, we present a rare case of penile fracture during sexual intercourse. The patient presented with penile swelling, bleeding per urethra, and inability to pass urine. Retrograde urethrogram showed significant extravasation of contrast from anterior penile urethra and no contrast passing to proximal urethra. Surgical exploration showed complete urethral rupture and bilateral cavernosal rupture. This case represents the value of urethrogram to evaluate the urethral injury and the association of complete urethral injury with bilateral ventral cavernosal injury.

scholarly journals Non sex-related subtotal rupture of the corpus cavernosum without urethral injury: A case report and literature review

2016 ◽  
Vol 88 (3) ◽  
pp. 233 ◽  
Author(s):  
Zeki Bayraktar ◽  
Selami Albayrak
Keyword(s):  
Surgical Repair ◽  
Tunica Albuginea ◽  
Correct Diagnosis ◽  
Corpus Cavernosum ◽  
Early Surgery ◽  
Urethral Injury ◽  
Penile Fracture ◽  
Minimal Rate ◽  
The Right

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.

scholarly journals Penile Fracture - Our Initial Experience and Outcome

2020 ◽  
Vol 7 (51) ◽  
pp. 3070-3073
Author(s):  
Fayaz Ahmad Najar ◽  
Peer Hilal Ahmad Makhdoomi ◽  
Tajamul Rashid
Keyword(s):  
Tunica Albuginea ◽  
Functional Results ◽  
Sexual Problem ◽  
Urethral Injury ◽  
Penile Fracture ◽  
Surgical Exploration ◽  
Egg Plant ◽  
Keywords Fracture ◽  
History Of ◽  
Urethral Injuries

BACKGROUND Penile fractures occur when the engorged penile corpora are forced to buckle and “pop” under the pressure of a blunt sexual trauma, due to slippage of the penis out of the vagina during intercourse. Patients typically describe that a “plop” sound was followed by immediate de-tumescence, severe pain, and swelling, called as “egg-plant” deformity, as a result of the injury. The immediate surgical exploration with evacuation of the haematoma and repair of tunica albuginea defect is the ideal treatment. METHODS Over a period of more than 3 years between May 2015 and January 2019 we have treated 26 patients with penile fractures. All of them presented within 24 hours after sustaining the injury. None had associated urethral injury. Apart from clinical examination and history the investigation most commonly used by us to aid diagnosis was Ultrasound (USG) and colour doppler which helped in identifying the site and size of the defect as well as the blood collections. All were treated by surgical exploration. RESULTS Patients were discharged either on 2nd or 3rd post-operative day. None of our patients developed any postoperative wound infection. Post-operative hematoma developed in 01 patient. 01 patient had complaints of slight bend of the penis to the affected side but with no sexual problem. There was no history of erectile dysfunction in any of these patients. CONCLUSIONS To diagnose penile fracture, our study relied on history and physical examination mainly and did not recommend imaging, except for, in patients with possible urethral injuries. Immediate surgical intervention can make good functional results and surgical exploration can be considered in all cases of penile fractures. The procedure is simple with minimal morbidity, low morbidity and short hospital stay. KEYWORDS Fracture, Corpora, Tear

scholarly journals Traumatic penile fracture with bilateral corporeal rupture

2021 ◽  
Vol 2 (2) ◽  
pp. 61-65
Author(s):  
SORIN NEDELEA ◽  
IULIAN SLAVU ◽  
ANDREI SIN ◽  
OCTAVIAN PATRASCANU ◽  
ADRIAN TULIN ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Tunica Albuginea ◽  
Rapid Onset ◽  
Corpus Spongiosum ◽  
Penile Fracture ◽  
Surgical Exploration ◽  
Penile Pain ◽  
Absorbable Sutures ◽  
Urological Emergencies

A 24-year-old man with no urological history presented to the emergency room for rapid onset severe penile pain, tenderness, swelling, and ecchymosis during vaginal sexual intercourse. Clinical examination was suggestive of penile fracture with a high suspicion of bilateral corporeal involvement. Urethrography excluded an injury to the corpus spongiosum. Surgical exploration confirmed the bilateral laceration of the corpora and tunica albuginea which was repaired with absorbable sutures.  Penile fractures are true urological emergencies whose surgical treatment must not be delayed to prevent long-term sequelae. Bilateral corporal rupture represents only 2-10% percent of penile fractures and usually involves the urethra, especially when the lacerations are situated ventrally.

scholarly journals OUTCOMES OF SURGICAL MANAGEMENT OF FRACTURE PENIS: EXPERIENCE FROM A TERTIARY CARE HOSPITAL IN BANGLADESH

2019 ◽  
Vol 5 (4) ◽  
pp. 122-130
Author(s):  
Md. Selim Morshed ◽  
AKM Musa Bhuyian ◽  
Mohammad Saruar Alam ◽  
Md. Towhid Belal ◽  
Sayem Hossain ◽  
...  
Keyword(s):  
Erectile Dysfunction ◽  
Erectile Function ◽  
Surgical Repair ◽  
Tunica Albuginea ◽  
Tertiary Care ◽  
Self Report ◽  
Care Hospital ◽  
Penile Fracture ◽  
Uncommon Presentation

Background: Penile fracture is an emergency and uncommon presentation to the urology department. Immediate surgical repair can be a standard of care for patients with penile fracture. Objective: The study was conducted to evaluate the outcome of surgical repair of the fractured penis.Methods: This quasi-experimental study was conducted from Jan 2017 to Dec 2018 in the urology department of Dhaka Medical College Hospital, Bangladesh. Thirty-five patients with fractures of the penis were included in this study. After proper evaluation, surgery was performed under spinal anesthesia. Follow up was scheduled at 6th week, 3rd month, and 6th month. We used validated questionnaires of the ‘International index of erectile function (IIEF-5)’ for married and ‘Single question self-report (SQSR)’ for unmarried patients to evaluate postoperative erectile function.Results: Total 35 patients completed three follow up. The mean age of patients was 36.4 years, and 88% of them were married. The most common triggers were for vigorous sexual intercourse (68.5%) followed by history of rolling over in bed with erect penis (20.0%). Per-operative findings were: rupture of tunica albuginea (100%); rupture of corpora cavernosa on the right (65.7%). After 6th month, 28 patients (80%) were able to maintain their normal erectile function. However, seven patients developed erectile dysfunction, of which 4 had a mild form, and 3 had mild to moderate form erectile dysfunction. All patients complained of pain during or after intercourse, but the pain has gradually subsided with time.Conclusion: Immediate surgical exploration and repair of fracture penis can offer complete recovery of sexual and voiding functions.

scholarly journals Primary urethral reconstruction results in penile fracture

2018 ◽  
Vol 100 (1) ◽  
pp. 21-25 ◽  
Author(s):  
R Barros ◽  
MIS Silva ◽  
V Antonucci ◽  
L Schulze ◽  
L Koifman ◽  
...  
Keyword(s):  
Corpus Cavernosum ◽  
High Energy ◽  
Urethral Injury ◽  
Urethral Reconstruction ◽  
Urinary Flow ◽  
Penile Fracture ◽  
Urethral Stenosis ◽  
Absorbable Sutures ◽  
End To End ◽  
Urethral Lesion

Objective This study assessed primary urethral reconstruction results in patients with a penile fracture. Materials and methods Between January 2005 and April 2016, patients who underwent primary urethral reconstruction due to penile fracture were called for a follow-up. Epidemiological and clinical presentation data and operative findings were reviewed retrospectively. Partial urethral lesions were primarily treated with interrupted absorbable sutures over urethral catheter. In cases of complete urethral lesion, tension-free end-to-end anastomosis was performed. From the third month after surgery, all patients were interviewed using the International Prostate Symptom Score questionnaire and uroflowmetry. Retrograde urethrocystography was used in patients with urinary symptoms or altered uroflowmetry to rule out or confirm urethral stenosis. Results Of 175 patients with penile fractures, 27 (15.4%) had associated urethral injury. All patients were diagnosed with penile fracture by means of clinical history and physical examination. No subsequent examinations were conducted. Ages varied from 30 years to 58 years old (mean 39.2 years). All fractures resulted from sexual activity. Reported sexual positions were ‘doggy style’ position in eight cases (61.5%) and with the ‘man on top’ in five cases (38.4%). Ten patients (76.9%) experienced haematuria, ten (76.9%) had urethral bleeding and four (30.7%) suffered urinary retention. Unilateral and bilateral injury of the corpus cavernosum was observed in four (30.7%) and nine (69.2%) patients, respectively; partial injury was found in nine cases (69.3%) and complete urethral injury was noticed in four cases (30.7%). All cases of complete urethral injury were associated with bilateral lesion of the corpus cavernosum. Six patients who had uroflowmetry with maximum urinary flow rate below 15 ml/s and/or had IPSS above 7 underwent retrograde urethrocystogram, and this was normal in all cases, excluding the possibility of urethral stenosis. Two patients (15.3%) experienced surgical postoperative complications represented by an urethrocutaneous fistula and a subcutaneous abscess adjacent to the end-to-end anastomosis area. Conclusions Penile fracture is a rare urological emergency, especially when it is associated with a urethral lesion. This must be suspected when the clinical picture is suggestive or in cases of high-energy trauma, especially in bilateral lesions of the corpus cavernosum. Complementary imaging methods are not needed in these cases and immediate exploration should not be delayed. Primary urethroplasty produces satisfactory results with low complication levels. Nonetheless, prospective studies with larger samples should be conducted.

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