The patient recovered well in hospital and was discharged in postoperative day 3 on antibiotics with Foley catheter. The urethral catheter was removed on day 21 postop. Discussions Fracture of the penis is a rupture of the tunica albuginea of the corpus cavernosum, usually while the penis is rigid and erect. In consequence the erect penis in much more vulnerable to serious damage from blunt trauma than the flaccid penis.
The majority of cases occured during sexual intercourse. Usually the penis slips out of the vagina and then it thrust against the perineum or pubic bone, which results in a tear of the tunica albugineea.
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Clinically in the clasical presentation the penis is deviated often to the opposite side of the injury secondary to mass efect of the hematoma at the injury site. It has been suggested that traumatic penile ruptures are the consequence of some histologic changes in the tunica albuginea.
Some studies have documented fibrosclerosis and cellular infiltrates in ruptured tunica albuginea that could predispoze to rupture at low pressures than with healthy tunica. Numerous reports show the accuracy of cavernosonography and MRI of the penis to diagnose the lesion. Studies comparing surgical versus conservative treatment favour immediate surgical exploration and reconstruction.
Conservative treatments have included compression bandages, ice packs, fibrinolytics, anti-inflamatories, sedatives and anti androgens. The complications cited are: angulation, persistent clot, penile abcess due to infected heamatoma or persistent extravasation of urine, painful markedly deformed erection, fibrotic plaque formation, corporeal-urethral fistula.
We also advocate for early surgical repair.
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Our center experience registered 44 cases af penile trauma between january january The justification for degloving that represents an extensive exposure is to obtain complete access to all three corporal bodies, as well as the neurovascular bundles. This type of incision present in our opinion an advantage in lesions situated at the base of the penis comparative with degloving because if we perform degloving all the penile shaft skin will be rolled at the penile base an the surgical exploration could be difficult having all this rolled skin covering the defect aria.
Complex penile fracture with bilateral corporeal ... - Revista Urologia
In complex lesions of the distal penile the circumferential subcoronal, degloving incision is superior to the longitudinal direct incision.
Complete urethral transections should be repaired immediately.
Spongiosum shoud be dissected from corporeal bed, the ends of urethra should be debrided, spatulated and reanastomosed in a tension free manner over a Foley catheter. Urgent surgical exploration and repair should be done in order to improve outcomes.
Urethral injury should be suspected in penile fracture especially in those cases with bilateral cavernosal ruptures or prostate opération conséquences clinical features. The key indicators of urethral injury include blood at the meatus, gross haematuria, dysuria or acute urinary retention. The surgical goals are restoration of penis to preinjury state, preservation of penile length, erectile function and voiding status.
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Complex cases such the one presented shoud be operated by surgeons with experience in prostate opération conséquences and urethral surgery.
As genital function has a strong impact on quality of life especially in young patients, it is important that the treating physician for genital trauma be knowledgeable about genital anatomy, as well as its immediate treatment and eventual reconstruction.
I1, Nr. Formost patients, adhesions formation has little effect.
References: 1. Genoa G. Ferguson and Steven B. Nathan A. De Rose A. Traumatic rupture of the corpora cavernosa: new physiopathologic acquisitions Urol ; 4.
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Surgical treatment of deformity prostate opération conséquences coital difficulty in healed traumatic rupture of the corpus cavernosa J Urol ; ; 5. Fracture shaft of penis. Non surgical treatment of three cases. J R Coll Surg Edinb ; 6.
Penile rupture. Urol Clin North Am ; 7.
Rupture of the corpus cavernosum: surgical management. J Urol ; Masarani M, Dinneen M. Penile fracture: diagnosis and management.
Trends Urol Gynaecol Sex Health prostate opération conséquences Penile fractures: evaluation, therapeutic approaches and long-term results. Experience with penile fractures in Egypt: long-term results of immediate surgical repair. J Trauma ; Kamdar C. Moppan UM, Kim H.