Fracture of the penis – Tips from Other Journals
Fracture of the penis is defined as a rupture of the tunica albuginea of the corpus cavernosum. It occurs as a result of blunt trauma to an erect penis. Controversy exists regarding the management of penile fracture. Conservative treatment usually consists of splinting the penis, application of a pressure dressing over a bladder catheter, application of ice and administration of sedatives. Lehman and Kremer present two cases in which the patients were treated surgically.
The first patient was a 23-year-old man who presented to a family practice clinic because of a painful, swollen penis. On the previous day, he had awakened in the morning with an erection, and injured his penis by rolling over on it. The penis became progressively swollen and tender. Ecchymosis and edema developed, with extension both dorsolaterally and ventrolaterally. Physical examination revealed deviation of the penis to the left. The results of urinalysis and a retrograde urethrogram were normal. The patient was then taken to the operating room where penile exploration, debridement and drainage, and closure of a 1-cm tear in the tunica albuginea were performed. The patient was discharged in good condition on the third postoperative day.
The second case was a 25-year-old man who sustained a blunt injury to the penis during sexual intercourse. There was immediate detumescence and extreme pain. Marked swelling and ecchymosis developed, with tenderness and hematoma formation at the left base, extending to the perineum and infrapubic area. The results of a retrograde urethrogram were normal. Surgical closure of the tunica albuginea was successful.
The authors believe that immediate surgical repair of the tunica albuginea decreases morbidity and shortens the period of hospitalization following this injury. Early surgical intervention and evacuation of the hematoma followed by primary closure of the tunica albuginea should be performed for fracture of the penis. (Surgery, Gynecology and Obstetric August 1990, vol. 171, p. 148.)
COPYRIGHT 1990 American Academy of Family Physicians
COPYRIGHT 2004 Gale Group