The most common form of penile fracture involves abnormal bending of the erect limb during sexual intercourse. The case, which has already been covered in Grey’s Anatomy, a popular medical series known for illustrating unusual clinical conditions, is real, although rare.
One studypublished in the scientific journal International Journal of Surgery Case Reports, reports an even more unusual episode of penile fracture that reached three points of the organ: two cavernous bodies and a spongy body, with associated urethral injury.
Immediate surgical repair is considered the gold standard treatment for penile fractures. If not treated well, the problem can lead to a number of complications, from penile scarring to erectile dysfunction.
How did the fracture occur?
Penile fracture is an uncommon urologic emergency, defined as rupture of the penile cartilage due to blunt trauma to the erect organ. The penile cartilage, also called the tunica albuginea, is a resistant structure, formed by two sheets, which covers the two corpora cavernosa and the corpus spongiosum.
With a flaccid penis, the structure is thicker, but it shrinks by 87.5% when it becomes erect. In this context, a sudden increase in pressure, such as a “slip” during more intense intercourse, can result in rupture of the erect penis.
The case presented is of a 36-year-old male from Tanzania, who was admitted to a public health center and teaching hospital, reporting complaints such as swelling, pain and blood in the urethra for five hours.
According to the study, the patient reported hearing a sudden ‘pop’ sound during intercourse with his partner, when the penis slipped, lost its way and hit the female perineal area.
The sound was followed by rapid loss of erection, pain, blood from the urethra and swelling of the penis. The symptoms prompted the man to seek out a nearby health center, where he was given painkillers and taken to hospital.
The study reports that upon admission to the hospital, the patient had mild pain, a swollen and slightly twisted penis, in addition to blood in the urethra region. The initial diagnosis of penile fracture with associated urethral injury was then considered by the team.
The penile ultrasonography showed a hematoma in the body of the penis in corpora cavernosa on both sides of the organ, more markedly on the left side. Magnetic resonance imaging revealed the three fracture sites.
The patient was taken for emergency surgery and repair of the penile fracture and urethral injury, which was performed by a urologist. According to the study, there were no other sites of injury other than those seen on MRI.
The repair of both corpora cavernosa was performed, while the urethra (considered corpus spongiosum) underwent a surgical amendment with a type of suture that is absorbed by the body over time.
The man recovered well and was discharged on the third postoperative day, according to the study. A urethral catheter, which had been implanted, was removed after 21 days postoperatively.
Six months after the operation, he returned to the clinic, reporting to the doctors that he had resumed his sex life without any difficulties.
“Penal fracture involving all three bodies and associated urethral injury is an extremely rare urological emergency. Although the diagnosis of penile fracture is clinical, magnetic resonance imaging can help with the diagnosis and delineate the extent of the injury. Urgent surgical repair of triple penile fracture has excellent outcome, including recovery of erectile function,” the researchers state in the article.
Source: CNN Brasil
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