Penile fracture

Penile fracture refers to a serious injury to the penis, specifically the rupture of one or both tunica albuginea, the fibrous envelope of the corpora cavernosa. This injury is typically the result of a sudden, blunt force applied to an erect penis and often occurs during sexual intercourse or aggressive masturbation. This condition may also include additional injuries to the urethra, dorsal nerves, veins, or arteries of the penis.

Penisfraktur 01

Anatomy and Pathophysiology

Penile fracture - risk

The penis's corpora cavernosa, enclosed by the tunica albuginea, are primarily involved in penile erection. The tunica albuginea, a tough fibrous layer, maintains the rigidity of the erect penis. When a blunt force is applied to the erect penis, the pressure within the corpora cavernosa can exceed the tunica albuginea's strength, leading to a fracture or rupture.

Clinical Presentation

Patients with a penile fracture typically present with a history of trauma to the erect penis. This trauma often results in a loud cracking or popping sound, immediate detumescence (loss of erection), and significant pain. Physical examination frequently reveals penile bruising, swelling, and deviation of the penis to the side opposite the fracture.

Diagnosis

Diagnosis of a penile fracture is primarily clinical, based on patient history and physical examination. If there is uncertainty, imaging studies like an ultrasound, MRI, or a retrograde urethrogram (if urethral injury is suspected) may be used.

Treatment and Prognosis

Prompt surgical repair is the standard treatment for penile fracture, as it can reduce the likelihood of complications like erectile dysfunction, penile curvature (Peyronie's disease), or painful erections. Conservative management is generally reserved for minor injuries with no urethral involvement.

References

Penile fracture Resources
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