Penile fracture after nerve-sparing radical prostatectomy: Case report and review of literature

Abstract

Introduction: Penile fractures typically do not occur in patients unable to maintain an adequate erection. Erectile dysfunction is known as one of the major complications of radical prostatectomy, and no cases of postoperative penile fractures have been reported.

Case presentation: A 78-year-old male with a history of radical prostatectomy with bilateral nerve-sparing for prostate cancer 12 years ago presented with a penile injury sustained during erection. Clinical examination showed subcutaneous hemorrhage and swelling throughout the penis, and magnetic resonance imaging showed discontinuity of the tunica albuginea. Emergent repair identified and corrected a laceration on the right lateral corpus cavernosum. He reported no complications and could maintain an erection after the surgery.

Conclusion: This is the first reported case of penile fracture following radical prostatectomy, as well as the eldest case of penile fracture to date.

Keywords: erectile dysfunction; male urologic surgery; penile erection; prostatectomy; trauma.

Fig. 1

Magnetic resonance imaging. T2‐weighted imaging demonstrating the discontinuity of the tunica albuginea on the right side of the mid‐shaft of the penis. The discontinuity is indicated by white arrows in the (a) coronal, (b) sagittal, and (c) axial views.

Fig. 2

Surgical findings. (a) Intraoperative view showing a subcutaneous hematoma localized to the right side of the mid‐shaft of the penis, consistent with the rupture site identified on imaging. (b) Postoperative appearance of the penis.