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Case Reports
. 2017 Feb 28;11(2):23-27.
doi: 10.3941/jrcr.v11i2.2907. eCollection 2017 Feb.

Isolated Spongy Urethral Rupture from Abrupt Coital Distractive Force

Brian J McArdle  1 , Mark A Wille  1 , Courtney Mp Hollowell  1
Affiliations
Case Reports

Isolated Spongy Urethral Rupture from Abrupt Coital Distractive Force

Brian J McArdle et al. J Radiol Case Rep. .

Abstract

The classic presentation of penile fracture is a cracking or snap sound, with sharp pain, immediate detumescence, swelling, deformation and ecchymosis. A penile fracture involves rupture of the tunica albuginea of one or both corpora cavernosa. Concomitant urethral rupture is reported to occur in 10% to 20% of penile fracture cases. Isolated urethral injury without penile fracture is extremely rare. We report the first case of isolated pendulous urethral rupture from an abrupt coital distractive force. We include a literature review and discussion of isolated urethral trauma secondary to sexual intercourse. Retrograde urethrography rendered a stunning clinical image which was integral to the diagnosis and management of this patient's injury.

Keywords: Coital; Coitus Interruptus; Corpus Spongiosum; Distractive Force; Extravasation; Isolated Urethral Rupture; Pendulous Urethra; Penile Trauma; Retrograde Urethrography.

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Figures

Figure 1
Figure 1
30-year-old heterosexual male with isolated pendulous urethral rupture from abrupt distractive force physical exam findings. FINDINGS: Physical exam reveals uncircumcised phallus, with peri-meatal ecchymosis and bloody urethral discharge (circled). There is no penile or perineal ecchymosis and no structural deformity.
Figure 2
Figure 2
30-year-old heterosexual male with isolated pendulous urethral rupture from abrupt distractive force retrograde urethrography findings. FINDINGS: Retrograde urethrography reveals contrast extravasation with small filling defect along the ventral aspect of the pendulous urethra consistent with the urethral nodule palpated on physical exam. TECHNIQUE: X-Ray retrograde urethrography in oblique position with iodinated radiocontrast medium
Figure 3
Figure 3
30-year-old heterosexual male with isolated pendulous urethral rupture from abrupt distractive force delayed retrograde urethrography findings. FINDINGS: Retrograde urethrography with delayed exposure reveals intravasation of contrast into the penile venous architecture via extravasation into spongy tissue of the corpus spongiosum. It also demonstrates preservation of the deep penile fascia overlaying the corpus spongiosum (circled). TECHNIQUE: X-Ray retrograde urethrography in oblique position with iodinated radiocontrast medium
See this image and copyright information in PMC

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