Penile fracture

Case contributed by Dr Maulik S Patel

Presentation

Penile trauma 19 days back. History of hematuria at time of injury. Suprapubic cystostomy at present.

Patient Data

Age: 35 years
Gender: Male
Ultrasound

Left tunica defect is noted. Left cavernosal artery is intact.

Another smaller right tunica defect is noted. Right cavernosal artery is intact. 

Normal midshaft of the penis.

The last image is a split-screen shows normal and abnormal images.

Retrograde urethrogram

Fluoroscopy

Stricture and extravasation in the penile urethra.

Case Discussion

USG (19 days post-trauma) - Proximal part of the penile shaft is abnormal. There is ventral defect in tunica albuginea of left corpus cavernosum. The smaller ventral defect is seen in right corpus cavernosum.

USG on 1st day - Hematoma of about 25 mm was noted in the same region - proximal shaft - ventral aspect. Diffuse penile edema was present. Possible tear of tunica was suggested. However, defect could not be localized at that time. Corpus spongiosum showed some mass effect possibly by hematoma.

Retrograde urethrogram (courtesy - Dr NInad Shah) - Done after 15 days of trauma showed focal stricture with possible extravasation in proximal - penile urethra.

No MR was done.

Surgery - Findings confirmed both tunical tears. Urethral tear was also present at the same site.

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