Delayed Presentation of a Penile Fracture: A Case Report

Penile fracture is a urological emergency caused by blunt trauma to an erect penis. We report a case of a 40-year-old male who presented with a complaint of a painful swelling of the penis for 4 days. On examination, a flaccid swollen tender penis with bluish discoloration over the shaft and scrotum was noted. A clinical diagnosis of delayed penile fracture was made which was managed immediately surgically under spinal anesthesia. Ourreport emphasizes that penile fracture is diagnosed solely on a reliable history and clinical examination. It has outstanding outcome despite delayed presentation if treated promptly.

Isolated Fracture of the Corpus Spongiosum- A Rare Case with Atypical Presentation and Diagnostic Role of MRI

Penile fractures occur due to rupture of the corpora cavernosum or tunica albuginea secondary to blunt or sexual trauma to the erect penis. They typically present with rapid detumescence of the penis, with pain, swelling and ecchymosis. Approximately 10-20% of penile fractures involve the urethra. The report presents a 28-years-old male patient that complained of per-urethral bleeding, following an injury to an erect penis. With the help of MRI and intra-operative cystoscopy it was found that the injury exclusively involved corpus spongiosum. He subsequently underwent a penile exploration and repair of the spongiosal defect. At one year follow up, he had normal erections with no per-urethral bleed. This is a rare form of presentation of penile fractures with only a few cases reported in literature. Surgical exploration remains the gold standard and early exploration is recommended to avoid erectile dysfunction, corporal fibrosis and urethral strictures and MRI is an useful adjunct.

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

Penile fracture is an uncommon urological emergency especially in Bangladesh. The other name is traumatic rupture of the tunica albugenia and corpora cavernosa in 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.Herein, we report 2 cases of penile fracture with review of current literature regarding treatment options. Bangladesh Journal of Urology, Vol. 19, No. 2, July 2016 p.98-102

Penis morphology facilitates identification of cryptic African bat species

Africa hosts a high number of bat species, many of which have been poorly studied. Among African vesper bats (Vespertilionidae), some species are morphologically similar to each other, hampering identification in the field. Consequently, basic information on these species’ population dynamics, distributions, or behaviors is vague and/or incorrectly documented. Among some Vespertilionidae, variation in flaccid penis shape enables species identification. This variation in morphology is thought to have resulted from sexual selection operating on the erect penis. Furthermore, in the context of strong postcopulatory competition, divergence in sperm traits may have evolved among closely related species. These male reproductive characters have hitherto not been investigated in southern African vespertilionid bats. In this study, we present the morphology of flaccid penis, erect penis, and sperm, of six small vesper species, based on the prediction that these characters have evolved sufficiently toward different optima to allow species discrimination. Species identification based solely on the morphological characters of the penis entirely matched species identification based on traditional (craniodental) characters. We illustrate penis morphology of these species to assist with field identifications for future ecological, conservation, or behavioral studies. Sperm morphology was sufficient to discriminate between the different genera, but could not reliably separate Neoromicia nana, Ne. zuluensis, and Ne. capensis. Hence, we demonstrate that these difficult to identify species can be readily distinguished based on traits directly observable in the field and on living animals, which will lead to more focused field studies on these otherwise morphologically cryptic species. Finally, our comparisons of penis morphology support the suggestion that Hypsugo anchietae is better placed within the genus Neoromicia.

Diagnostic and management of penile fracture: A literature review

Penile fracture is a real urological emergency; it is underreported due to the shyness to describe it. It usually occurs during intercourse when the erect penis forcefully hits against the perineum or symphysis pubis. While imaging may be used as an adjunct to aid diagnosis, especially in equivocal cases, the diagnosis remains mostly a clinical one. Standard treatment is immediate surgical. Preferred incision to be employed is subcoronal circumferential incision with minimal complications and excellent results

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

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

Penile Fracture : Experience from a Tertiary Care Hospital

Introduction: Penile fracture is a misnomer,penile fracture is defined as rupture of the tunica albuginea of one or both corpus cavernosum. The usual cause is abrupt bending of the erect penis by blunt trauma, which may occur during sexual intercourse, masturbation, rolling over on the bed or falling onto the erect penis. Diagnosis of penile fracture is made on the basis of history and physical examination.standard mode of management is surgical.Methods: This retrospective study was conducted in the department of surgery SMHS hospital srinagar ,(Jammu and Kashmir), extending over a period of about three and a half years from june 2013 to January 2017 . All patients with diagnosed penile fracture were included in this study. All except one patient were operated one the same day of admission.Results: out of a total of 50 patients studied ,the mean age of presentation was 26.7 years.Majority (56%)were below 30 years of age.21 (42%) of the patients were married.majority42% of the patients reported masturbation as cause of trauma,followed by vaginal intercourse in38% and rolling on erect penis in 20%.About 80% patients gave history of audible click/crackling sound.All patients had swelling and discolouration on examination,90% patients had penile deformity,only 36 % had palpable defect.Dopler USG was correct in 93% patients.Majority (44%) patients had defect less than 1cm.defect was mostly seen on right side (68%).most patients had proximal penile defect (56%). Mean hospital stay was 2.9 days. One patient (2%) had urethral trauma.Surgery had a recurrence of 2%.and a total postoperative complication rate of 10%.Conclusions: Penile fracture though reported rarely, is a common entity. Penile fracture is a urological emergency.Diagnosis is mainly on clinical grounds.Immediate surgical repair is the standard treatment of penile fracture.

Penile fracture and investigation of early surgical repair effects on erectile dysfunction

Objectives: Penile fracture is one of the urological emergencies caused by direct trauma to an erect penis during sexual intercourse, which results in a tear in the tunica albuginea within the corpus cavernosum. Serious complications such as penile curvature and erectile dysfunction may develop due to inappropriate and/or late surgical repair. This study aims to evaluate patients with penile fracture and to describe their demographics, surgical repairs, and long-term outcomes. Materials and Methods: A total of 56 patients who were diagnosed with penile fracture between January 2012 and June 2017 were reviewed. Clinical features, pre-operative assessment, time from injury to surgery, tunica defect properties, and presence of urethral injury were assessed. Early surgical management was performed. Outcomes, including International Index of Erectile Function 5 pre-operation and after 6 months, were evaluated. Results: The mean age was 30.2 (18–57) years. In etiological questionnaires, 32 (57.2%) patients reported direct trauma to an erect penis during intercourse. The mean size of tunica defects was 1.61 ± 0.42 (0.3–3.6) cm of the nine (16%) patients, and penile fracture was associated with urethral injury. There was no significant difference in International Index of Erectile Function 5 scores before the surgery and 6 months after surgery. Penile skin necrosis developed in one patient 10 days post-operation. Conclusion: Early surgical repair could be an effective method of achieving post-operative erection success in patients with penile fracture due to direct trauma during intercourse.