Penile fracture grading

Last revised by Craig Hacking on 23 Oct 2019

A simple grading system for penile fracture has been developed but it is not widely used or validated nor recognized by relevant urological surgical societies. Regardless, this system which relies on ultrasound assessment of the tunica albugenia, corpora of the penis, urethra and other fascia 1 helps the sonorgapher and radiologist focus on key structures.


  • grade 0: intact tunica albugenia with a hematoma superficial or deep to Buck's fascia
  • grade I: defect in the tunica albugenia and/or corpora cavernosa
  • grade II: defect in the tunica albuginea and/or corpora cavernosum with associated peri-albugineal and/or cavernosal hematoma
  • grade III: defect in the tunica albuginea, Buck fascia (with hematoma) and the corpus spongiosum
  • grade IV: involvement of corpus spongiosum with urethra and/or vascular injury, with any vascular malformation

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Cases and figures

  • Figure 1: normal anatomy
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  • Figure 2: grade 0
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  • Figure 3: grade 1
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  • Figure 4: grade 2
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  • Figure 5: grade 3
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  • Figure 6: grade 4
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