Transcript Document

Dr. Subhash Goyal, Dr. Sankalp Dwivedi,
Dr.Mohinder Kumar, Dr. Kunal Chowdhary
[email protected]
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Penile fracture remains a rare, yet likely underreported
condition.
Fracture of the penis is a tear in the tunica albuginea of
the corpora cavernosa with or without injury to the corpus
spongiosum and urethra.
Diagnosis is usually clinical and urethral injury should be
suspected in penile fracture, especially in those cases with
bilateral cavernosal rupture.
The usual cause is abrupt bending of the erect penis by
blunt trauma most commonly during sexual intercourse.
A crackling sound, pain, detumescence, bruising, swelling,
and bleeding per urethra are the common symptoms
reported by the patients.
Early surgical management is the treatment of choice with
low incidence of complications
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We report a case of Fracture penis in a 35
year old male came to the emergency of our
hospital.
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History of pain, swelling, discoloration &
detumescence of the penis.
Patient gave history of sudden change of
posture while asleep with erect penis leading
to severe pain and onset of swelling about 6
hours back. Patient was able to pass urine
without difficulty and was not complaining of
blood over the urethral meatus.
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Physical examination
revealed a swollen,
ecchymotic penis.
Tenderness was present
over the shaft of the penis
more over the right side.
Glans penis was not visible
due to gross swelling of the
prepuce. Penis was flaccid
and deviated to the left side
with discoloration of the
penile shaft.
Swelling of prepuce with
detumescene
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On the basis of clinical examination diagnosis
of Fracture penis without involvement of
bulbar urethra was made and diagnosis was
confirmed by M.R.I penis.
M.R.I Penis showed a transverse tear in the
tunica albuginea of the rt corpora cavernosa
of about 4mm with Haematoma extending
between skin and tunica over the penile shaft.
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Patient was catheterized with foley 14 Fr and
routine blood investigation were done.
The patient underwent immediate surgical
exploration and repair of the fracture.
Circumferential subcoronal degloving incision
(circumcision – like) and hematoma evacuation
presented a partial tear of the tunica albuginea of
right sided corpus cavernosum .4/0 prolene
continuous sutures were used to repair rupture
of rt. corpus cavernosus. Skin closed with
prolene 4/0 suture.
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Penile fracture is a rare urological emergency.
Diagnosis is mainly clinical.
Immediate surgical intervention is required to
decrease the complications.
A sub-coronal or circumferential is the best
described surgical approach.
Other approaches described include
penoscrotal, inguinoscrotal, lateral and
suprapubic incisions.