Penile fracture: Difference between revisions
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{{Template:Penile Trauma DDX}} | {{Template:Penile Trauma DDX}} | ||
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*Retrograde urethrogram may be necessary to assure urethral integrity | *Retrograde urethrogram may be necessary to assure urethral integrity | ||
**Especially important if patient unable to urinate | **Especially important if patient unable to urinate | ||
Revision as of 13:19, 26 July 2016
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 swollen, discolored, tender, and flaccid
- Cracking sound followed by pain, detumescence, swelling, discoloration, deformity
Differential Diagnosis
Penile trauma types
Evaluation
- Retrograde urethrogram may be necessary to assure urethral integrity
- Especially important if patient unable to urinate
- Urology may request corpus cavernosography, MRI, or ultrasound if the penile fracture is atypical[2]
Management
- Surgical exploration required for most injuries if there is obvious or suspected fracture
- Hematoma evacuation and suture apposition of the disrupted tunica albuginea
- Penile Hematomas with no fracture can be treated with NSAIDs as an outpatient
- Lacerations without fractures can be closed with 5-0 or 4-0 absorbable sutures
Disposition
- Admit