Urethral injury in penile fracture: a narrative review
Rodrigo Barros1, José Genilson Alves Ribeiro1, Heleno Augusto Moreira da Silva1
1Departamento de Urologia, Universidade Federal Fluminense - UFF, Niterói, RJ, Brasil.
Insights
Penile fracture (PF) with urethral injury is a rare urological emergency. Urgent surgical reconstruction is mandatory and yields good outcomes with few complications.
Area of Science:
- Urology
- Trauma Surgery
Background:
- Penile fracture (PF) is an uncommon urological emergency.
- Concomitant urethral injury complicates PF, varying in incidence globally.
- Clinical presentation often includes blood at the meatus, hematuria, and voiding difficulties.
Purpose of the Study:
- To review the current literature on the etiology, diagnosis, management, and outcomes of penile fracture (PF) with associated urethral injury.
- To highlight recent data and clinical insights for this specific urological trauma.
Main Methods:
- A comprehensive literature search was conducted on PubMed.
- Keywords included "penile fracture", "rupture of corpora cavernosa", "urethral injury", and "urethral reconstruction".
- The search spanned from 1998 to 2019.
Main Results:
- Urethral injury incidence in PF varies geographically.
- Clinical signs like meatal bleeding, hematuria, and voiding issues strongly suggest urethral rupture.
- Diagnosis of PF is primarily clinical; imaging is generally not required.
- Treatment involves surgical urethral reconstruction.
- Common complications include urethral stenosis and urethrocutaneous fistula.
Conclusions:
- Penile fracture with urethral injury requires prompt clinical suspicion and diagnosis.
- Urgent surgical reconstruction is essential for optimal outcomes.
- The management approach leads to satisfactory results with a low complication rate.
Objective:
To present the evolution and the recent data on the etiology, diagnosis, management and outcomes of penile fracture (PF) with concomitant urethral injury.
Materials And Methods:
We searched the Pubmed database between 1998 and 2019 using the following key words: "penile fracture", "fracture of penis", "trauma to penis", "rupture of corpora cavernosa", "urethral injury", "urethral rupture" and "urethral reconstruction".
Results:
The incidence of urethral lesion in patients with PF varies by geographic region and etiology. Blood in the meatus, hematuria and voiding symptoms are highly indicative of urethral rupture. The diagnosis of PF is eminently clinical and complementary exams are not necessary. The treatment consists of urethral reconstruction and the most common complications found are urethral stenosis and urethrocutaneous fistula.
Conclusion:
PF is an uncommon urological emergency, particularly in cases with urethral involvement. Urethral injury should be suspected in the presence of suggestive clinical signs, and diagnosis is usually clinical. Urgent urethral reconstruction is man-datory and produces satisfactory results with low levels of complications.
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