![]() Workup surrounding penile fractures should include preoperative laboratory evaluation, and other studies to rule out concomitant urethral injury may be warranted. One study demonstrated 100% sensitivity along with 77.8% specificity for the identification of penile fracture by MRI. MRI, while not the most readily available test, has been shown to assist in the diagnosis and perioperative management of penile fractures. CT certainly is widely available and has been demonstrated to be helpful in identification in location and size of injury to aid surgical repair. However, if there is a significant hematoma, it may increase difficulty in the diagnosis of tunica rupture by the US. The US may show irregular defects at the site of cavernosa rupture. Ultrasound (US) is readily available in most areas however, there is some debate over its clinical utility as the actual test is operator dependent, and successful identification of injury requires specific expertise. In addition to clinical suspicion for tunica rupture, multiple imaging modalities can be useful to identify penile fractures. However, suspicion of penile fracture based on history should warrant a thorough evaluation to rule out compounded injuries, including dorsal penile vein and nerve injuries, while simultaneously correctly diagnosing the penile fracture. Ecchymotic shaft (an "eggplant" deformity)Ĭorrect identification of penile fracture is typically a clinical diagnosis.Physical exam should be comprehensive and may include the following findings: Bruising of the penis and surrounding area.Patients may report hearing a "pop" or "snap.".Often associated with an erect penis at the time of trauma.Typical historical findings commonly associated with penile fracture include the following: One study noted a disproportionately higher number of penile fractures occurring during the summer months and on weekends. As such, for all men who report urogenital trauma, penile fracture should remain in the differential regardless of sexual orientation. However, this injury can also occur in men who have sex with men (MSM) in one study, 1.8% of penile fractures were in the MSM population. Patients are typically heterosexual males, which lends to the classic teaching of penile trauma during intercourse, as described above. ![]() Penile fractures most commonly occur in middle-aged men multiple studies note that the average age of patients is between 30 and 50 years of age. This injury is isolated to persons with phenotypically male genitalia for obvious reasons. Masturbation injuries and falls landing on an erect penis are other notable causes of penile fracture. The most commonly associated sexual positions are "female superior" or "rear entry," however, one study noted that meta-analysis showed no sexual position had an increased risk. This pressure results in a tear of the tunica albuginea. This thrust results in increased pressure of the filled corpus cavernosa. The erect penis typically slips from the vagina and is thrust into either the perineum or pelvic bone. In one study, 57.2% of patients with confirmed penile fracture reported direct trauma to the erect penis during intercourse. Penile fracture is most commonly a direct result of trauma during sexual intercourse. Given the sequelae of this injury, this article will review the identification, prompt treatment, and long-term management of penile fractures. Penile fracture is considered a urological emergency. Delay in the treatment of penile fracture can lead to long-lasting sexual and anatomical dysfunction. This increased pressure, in turn, results in the rupture of the tunica albuginea. Direct trauma to an erect penis results in increased pressure in the cavernosa. ![]() Penile fracture is uncommon, but it is essential to note this specific urogenital injury. The majority of penile fractures occur with direct trauma during sexual intercourse. Describe some interprofessional team strategies for improving care coordination and communication to improve outcomes for patients affected by penile fractures.Identify management considerations for patients with a penile fracture.Review the typical presentation and physical exam findings in a patient with a penis fracture.Identify the etiology of penis fracture.This activity illustrates the evaluation and treatment of penis fractures and highlights the role of the interprofessional team in managing patients with this condition. Often the direct result of penile trauma during intercourse penis fractures has a deleterious effect on a patient's sexual health if left untreated. Penis fracture is an uncommon but severe injury. ![]()
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