Use of magnetic resonance imaging to guide direct repair of penile fractures---a change to the operative paradigm

Penile fractures are an uncommon urological emergency, typically diagnosed on clinical grounds and require urgent operative intervention. Examination findings include penile swelling bruising, commonly referred to as “eggplant deformity”. Close palpation identify the exact site of injury is often limited by pain. Subcoronal degloving, with concurrent circumcision most utilised surgical approach, though risks skin necrosis decreased sensitivity. Magnetic Resonance Imaging (MRI) for fracture diagnosis increasingly recognised, however, its ability guide localised longitudinal incisions currently undefined. A multi-centre retrospective observational study from February 2016 2022 was performed. Electronic medical records were reviewed patient demographics, presentation, characteristics, investigations outcomes. MRI use protocols determined at discretion treating urologist on-duty radiologist respectively. Twenty-one patients eligible inclusion. Ten underwent pre-operative MRI. Median time request image acquisition 2.5 hours (1.5–3.0). Time presentation intervention did not significantly differ between two groups. All without subcoronal degloving. Six MRI-guided incision successfully requiring secondary or conversion The remaining four in cohort Operative times shorter (p = 0.44) group, a median duration 1.11 (0.98–1.17), compared 1.5 (1.20–1.75) non-MRI cohort. length stay 1 day both No Clavien Dindo 2 greater complications observed any patient. In this study, setting associated reduced used direct repair fractures. Its has potential change paradigm management repair.