Published Online: Jun 16, 2024
Page range: 61 - 68
DOI: https://doi.org/10.2478/bgbl-2024-0005
Keywords
© 2024 Jędrzej J. Ksepka et al., published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial 4.0 International License.
Introduction
Penile fracture is a rare urological condition and its occurrence rate is 1 in 175,000 cases. It usually occurs during sexual intercourse or masturbation after sudden penile flexion, resulting in a rupture of the tunica albuginea surrounding the cavernous bodies of the penis. Treatment involves immediate surgery, within 24 hours after the injury, which reduces the risk of long-term complications such as painful erections or erectile dysfunction.
Case report
We present the case of a 42-year-old male who was admitted to the Emergency Department due to sudden penile pain and swelling during sexual intercourse. The acute pain was preceded by a popping sound, whereas accompanying symptoms included swelling and leakage of a small amount of blood from the urethra. Physical examination revealed bruising and penile deformation (eggplant sign). The ultrasound of the penis showed a rupture of the tunica albuginea near about half the length of the penile body on the left side and an accumulation of a heterogeneous 10x15 mm mass surrounding the tunica albuginea – a subcutaneous hematoma. A retrograde urethrography was performed, obtaining a normal urethral contrast , which ruled out urethral injury. The patient was then catheterized with an 18CH Foley catheter. Approximately 30 hours after the injury, the surgery was performed. The patient was discharged from the hospital on the 3rd day in good condition. During a follow-up visit 7 days after the procedure, the wound was found to be healing properly and after 30 days, the patient had no erectile dysfunction or painful erections.
Conclusions
Thanks to the confirmation of the clinical symptoms by ultrasound, there was no need to perform an MRI, which would have delayed the surgery. Despite surgical exploration, after 30 hours, the patient fully recovered and long-term complications were avoided.