Paul Spiesecke 1, Josef Mang 2, Thomas Fischer 1, Bernd Hamm 1, Markus H Lerchbaumer 1Transl Androl Urol. 2022 Mar;11(3):377-385.
COMMENT
Penile fracture(PF) is a type of penile trauma that requires emergency intervention (1-3). PF is defined as the rupture of the tunica albuginea (TA) of the corpora cavernosa (CC) caused by blunt trauma to the erect pênis. In most cases, that occurs during sexual relations, when the penis slips out of the vagina and strikes against the symphysis pubis or perineum and is more likely when the partner is on top (4-6).
The diagnosis of penile fracture is mainly clinical, made from a thorough history and physical exam alone (7-9). The patient often reports blunt trauma during intercourse accompanied by an audible “snap” or “pop,” followed by immediate pain and rapid detumescence. Physical exam findings may include edema, ecchymosis, and penile deformity, classically described as an “eggplant deformity” (1).
In the present paper the authors studied the further evidence concerning the diagnostic accuracies of magnetic resonance imaging (MRI) and ultrasound (US) in the diagnostic assessment of patients with suspected PF and concluded that the results of this study suggest that MRI is more suitable to confirm PF and identify the site of the associated tunica albuginea tear while US is a good tool for ruling out PF.
REFERENCES
- 1.Koifman L, Cavalcanti AG, Manes CH, Filho DR, Favorito LA. Penile fracture - experience in 56 cases. Int Braz J Urol. 2003;29:35–39. doi: 10.1590/s1677-55382003000100007. [DOI] [PubMed] [Google Scholar]
- 2.Kamdar C, Mooppan UM, Kim H, Gulmi FA. Penile fracture: preoperative evaluation and surgical technique for optimal patient outcome. BJU Int. 2008;102:1640–1644. doi: 10.1111/j.1464-410X.2008.07902.x. discussion 1644. [DOI] [PubMed] [Google Scholar]
- 3.Patil B, Kamath SU, Patwardhan SK, Savalia A. Importance of time in management of fracture penis: A prospective study. Urol Ann. 2019;11:405–409. doi: 10.4103/UA.UA_80_18. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 4.Barros R, Silva M, Antonucci V, Schulze L, Koifman L, Favorito LA. Primary urethral reconstruction results in penile fracture. Ann R Coll Surg Engl. 2018;100:21–25. doi: 10.1308/rcsann.2017.0098. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 5.Barros R, Schulze L, Ornellas AA, Koifman L, Favorito LA. Relationship between sexual position and severity of penile fracture. Int J Impot Res. 2017;29:207–209. doi: 10.1038/ijir.2017.24. [DOI] [PubMed] [Google Scholar]
- 6.Barros R, Guimarães M, Nascimento C, Jr, Araújo LR, Koifman L, Favorito LA. Penile refracture: a preliminary report. Int Braz J Urol. 2018;44:800–804. doi: 10.1590/S1677-5538.IBJU.2018.0124. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 7.Muentener M, Suter S, Hauri D, Sulser T. Long-term experience with surgical and conservative treatment of penile fracture. J Urol. 2004;172:576–579. doi: 10.1097/01.ju.0000131594.99785.1c. [DOI] [PubMed] [Google Scholar]
- 8.Sokolakis I, Schubert T, Oelschlaeger M, Krebs M, Gschwend JE, Holzapfel K, et al. The Role of Magnetic Resonance Imaging in the Diagnosis of Penile Fracture in Real-Life Emergency Settings: Comparative Analysis with Intraoperative Findings. J Urol. 2019;202:552–557. doi: 10.1097/JU.0000000000000211. [DOI] [PubMed] [Google Scholar]
- 9.Spiesecke P, Mang J, Fischer T, Hamm B, Lerchbaumer MH. Diagnostic performance of MRI and US in suspicion of penile fracture. Transl Androl Urol. 2022;11:377–385. doi: 10.21037/tau-21-957. [DOI] [PMC free article] [PubMed] [Google Scholar]