Fractured penis: diagnosis and management

Abstract

Introduction: Penile fracture is a well-recognized clinical entity. It is relatively uncommon and is considered a urological emergency. Its management has been a subject of controversy.

Aim: In this article, we will review contemporary knowledge of the epidemiology, pathophysiology, evaluation, and evolving management strategies of penile fracture.

Methods: A case report was discussed followed by an English-language Medline review.

Main outcome measure: Review of the available literature to establish best-practice management.

Results: The injury is defined as the traumatic rupture of the corpus cavernosum secondary to a blunt trauma of the erect penis. The condition is underreported. The commonest causes were coital injuries and penile manipulation. The diagnosis was usually fairly straightforward because of the stereotypical clinical presentation. Associated injuries included urethral rupture. Imaging was helpful in selected cases. Conservative measures were associated with increased complications. Most authors advocated early surgical repair. False explorations have been reported.

Conclusions: Penile fracture is a clinical diagnosis. The ideal management has evolved and remains largely surgical. Preoperative imaging should not delay surgical repair.