Hospital: Hospital Son Llátzer.
Ciudad:
Nº:
Aut@r o Autores: J. Cisternas, S. Martín, M. González, R. Alarcón.,
Presentación:
A 36-year-old male presented to the emergency department of our hospital referring pain and swelling of the penis after noticing a ‘snap’ during sexual intercourse, immediately following contusion with the erect penis. Physical examination revealed haematoma along the contour of the penis to the base and root, with deformity to the left, and normal testes. With the suspected diagnosis of a penile fracture, the patient was evaluated with ultrasound, which revealed a large haematoma from the base to the head of the penis surrounding the left corpus cavernosum, along a tearing of the tunica albuginea of approximately 1cm in length between the mid and proximal third of the ventral aspect of the penis. There were no alterations in the right corpus cavernosum, or the corpus spongiosum.These findings confirmed the diagnosis of a penile fracture, and the patient underwent emergent surgery for suture of the defect in the tunica albuginea.
Discusión:
Penile fracture is a rare urological emergency that occurs when there is rupture of the tunica albuginea and corpora cavernosa, in the great majority of cases it is associated to trauma during sexual intercourse. It can be associated with urethral injury in up to 38% of cases, which should be especially suspected if there is blood in the urethra, haematuria, or urinary retention.Ultrasound is recommended as first-line imaging, and the main radiological findings are: 1. Disruption of the tunica albuginea. 2. Haematoma, appearing as hypoechogenic areas. 3. Arteriovenous fistulae. Ultrasound is helpful not only in confirming the diagnosis, but also to aide in planning the surgical approach by identifying the site of injury and defining its extension.
Conclusión:
Penile fracture is a rare urological emergency that occurs when there is rupture of the tunica albuginea and corpora cavernosa, in the great majority of cases it is associated to trauma during sexual intercourse. It can be associated with urethral injury in up to 38% of cases, which should be especially suspected if there is blood in the urethra, haematuria, or urinary retention.Ultrasound is recommended as first-line imaging, and the main radiological findings are: 1. Disruption of the tunica albuginea. 2. Haematoma, appearing as hypoechogenic areas. 3. Arteriovenous fistulae. Ultrasound is helpful not only in confirming the diagnosis, but also to aide in planning the surgical approach by identifying the site of injury and defining its extension.
Bibliografía:
– Nicola R, Carson N, Dogra VS. Imaging of traumatic injuries to the scrotum and penis. Am J Roentgenol, 2014, 202(6): 512-20. – European Association of Urology. Urological Trauma, 2018. Retrieved from https://uroweb.org/guideline/urological-trauma/#4_5