Penile rupture

Rupture of the corpus cavernosum is a rare injury; the characteristic history and physical findings usually yield the diagnosis. Blood at the meatus, any degree of hematuria, and difficulty with urination are suggestive of associated urethral injury, which occurs in 10 to 20 per cent of patients and indicates the need for retrograde urethrography. A review of the literature suggests that early surgical repair of the tunical defect is associated with a significantly lower risk of persistent penile angulation, a shorter hospital stay, and more rapid functional return. Conservative treatment may be warranted in cases with minimal hematoma if cavernosography reveals no extracorporal extravasation. Complete urethral disruption is best managed by primary repair, whereas partial disruption can be managed adequately by temporary suprapubic cystostomy. By following these guidelines, long-term morbidity can be kept to a minimum.