Penile fracture and magnetic resonance imaging.

A thirty-three-year-old male presented to an outside emergency department with scrotal swelling and pain after intercourse. A scrotal ultrasound revealed hematoma, with no other abnormalities and the patient was discharged. He then presented to our institution where examination showed diffuse ecchymosis through the shaft of the penis, suprapubic region, and scrotum without a palpable cavernosal defect. Magnetic resonance imaging (MRI) without contrast was obtained after the injection of 10 micrograms of intracavernosal alprostadil. The low signal tunica albuginea is easily demarcated compared to the high T2 and intermediate T1 signal of the corpora cavernosum (Figures 1-3) (1,2). Hematoma shows heterogeneous intermediate T1 and T2 signal (Figures 2 and 3) (1). Penile fracture is rupture of the corpus cavernosum from blunt trauma to the erect penis (3,4). Typical presentation is a pop during intercourse, immediate detumescence with edema, hematoma and penile deformity (3,4). In atypical presentations, radiological studies may be useful to determine the diagnosis. MRI provides the ability to identify disruption of the corpus cavernosum due to excellent tissue contrast and Penile Fracture and Magnetic Resonance Imaging _______________________________________________