Penile fracture: Difference between revisions
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*Typically occurs during intercourse with receptive partner on top | *Typically occurs during intercourse with receptive partner on top | ||
*Cracking sound followed by pain, usually immediate detumescence, swelling, discoloration, deformity | *Cracking sound followed by pain, usually immediate detumescence, swelling, discoloration, deformity | ||
File:Penile Fracture. | [[File:Penile Fracture.JPG|thumb]] | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
Revision as of 18:58, 26 July 2021
Background
- Tunica albuginea of one or both corpus cavernosa ruptures due to trauma to erect penis
- Can be associated with urethral rupture and deep dorsal vein injury
- Unlikely to occur in blunt pelvic trauma with a flaccid penis
- Associated with a urethral injury in up to 38% of penile fractures[1]
Clinical Features
- Penis is circumstantially swollen, discolored, tender, and flaccid
- Typically occurs during intercourse with receptive partner on top
- Cracking sound followed by pain, usually immediate detumescence, swelling, discoloration, deformity
Differential Diagnosis
Penile trauma types
Evaluation
- Clinical diagnosis
- Rule out other trauma
- Do NOT pass foley until confirming patient can pass urine OR
- Retrograde urethrogram may be necessary to assure urethral integrity (especially important if pt unable to urinate)
- Urology may request corpus cavernosography, MRI, or ultrasound if the penile fracture is atypical[2]
Management
- Surgical exploration/repair required for most injuries if there is obvious or suspected fracture
- Penile hematoma with no fracture can be treated as an outpatient with NSAIDs
- Penile laceration with no fracture can be closed with 4-0 or 5-0 absorbable sutures
Disposition
- Admit, usually to OR for operative repair