Surgical Correction Of A Penile Fracture

SavageGlow · #1 ● 07-12-2024, 04:21 PM

A 38-year-old male presented to the emergency department 14 hours after experiencing acute penile pain and swelling during sexual intercourse. He reported hearing a sudden "cracking" sound, followed by immediate pain, penile deformity, and scrotal edema. Physical examination revealed a swollen, deviated penis with notable hematoma and scrotal edema with no blood at the tip of the urethral meatus, features suggestive of penile fracture (Figure 1). Urgent penile ultrasound also confirmed disruption of the tunica albuginea near the root of the penis, with a substantial hematoma present, no urethral injury was detected (Figure 2).

The patient was taken to the operating room for urgent surgical exploration. A circumferential subcoronal degloving incision was performed, exposing the penile shaft. Intraoperatively, there were bilateral corpus cavernosal tears near the penile root with hematoma with American Association for the Surgery of Trauma (AAST) grade 2 for penile fracture (Figure 3). The hematoma was meticulously evacuated, and the bilateral tears in the tunica albuginea were repaired using vicryl 3-0 absorbable sutures with a simple interrupted technique (Figure 4).

Postoperatively, the patient was discharged with a prescription for amoxicillin-clavulanate 625 mg to be taken thrice daily for seven days, along with a Foley catheter in situ. He was instructed to abstain from sexual activity and masturbation for at least four weeks and was educated on performing daily home dressing. The Foley catheter was subsequently removed after one week. At the third-week follow-up, the surgical site appeared healthy and free of discharge, and the patient reported no penile curvature during erection. He expressed satisfaction with the overall outcome.