Penile fracture.

A 46-year-old man came to the emergency department with complaints of pain and swelling of the penis that he had experienced for approximately 1 hour. He had been having intercourse with his wife; he had withdrawn his penis and, upon thrusting, missed the vagina and hit his penis against her pubis. He reported hearing a cracking noise and having immediate detumescence and pain; a large hematoma had formed on the left side of the penis. He said he was able to void after the incident with slight discomfort, but he reported no hematuria. On examination, a large, purplish hematoma extended along the entire left side of the penis, which deviated away from the involved side. There was no palpable defect in the penile shaft. The glans and scrotum were not involved. Urinalysis was negative for blood. A urologist was consulted. Because a fracture of the corpus cavernosum was suspected, the patient was taken to the operating room, where a large rent in the proximal left corporum cavernosum was repaired with absorbable sutures. He did well postoperatively, and only a small amount of scar tissue was noted at the fracture site. He had no further deviation of the penis and had normal erections.