Penile fracture with urethral injury: evaluation by contrast imaging.

To cite: Garg M, Goel A, Dalela D, et al. BMJ Case Rep Published online: [please include Day Month Year] doi:10.1136/bcr-2013010318 DESCRIPTION A 50-year-old man presented with penile pain and swelling for 24 h prior to the visit. The patient revealed the sudden development of pain during intercourse with history of striking of the erect penis against the partner’s perineum. He had the sensation of ‘tearing’, and rapid detumescence after that. He had slight haematuria initially but was able to void well. On physical examination, penile swelling was found but there was no blood at the urethral meatus (figure 1). Retrograde urethrogram was suggestive of a rare and interesting image of a collection of the contrast agent in the ruptured corpora cavernosa which entered through urethral tear in the distal penile urethra (figure 2). The urethroscopy was suggestive of a rent (figure 3) in the right dorsolateral part of the distal penile urethra with collection of clots in the ruptured corpus cavernosum (figure 4). Surgical management was conducted immediately and after evacuation of blood clots, tear in the corpus cavernosum was sutured. The urethra was also repaired in a watertight fashion after spatulation and 16 F Foley catheter was inserted. In follow-up period the patient was asymptomatic with no complications. The penile fracture remains an uncommon entity and diagnosis is usually clinical. Any associated urethral injury usually occurs with penile fracture