Penile fracture

Definition

Penile fracture is a tear of the tunica albuginea of a corpus cavernosum during erection, usually caused by traumatic bending of the penis.

Clinical presentation

• A characteristic cracking sound at the time of injury.
• Immediate loss of erection.
• Acute pain.
• Rapidly expanding hematoma and swelling (“eggplant deformity”).
• Deformity (curvature toward the tear).
• Possible urethral injury (urethral bleeding).

Diagnosis

• The diagnosis is clinical.
• Ultrasonography may confirm the tunica albuginea defect.
• Urethrography if urethral trauma is suspected.

Emergency management

• Emergency surgical treatment:
• Incision and hematoma evacuation.
• Repair of the tunica albuginea defect.
• Repair of the urethra if injured.
• Conservative treatment (cold application, immobilization) is not recommended, as it leads to curvature and erectile dysfunction.

Algorithm