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Penile Fractures: Evaluation and Management.

Allen Simms1, Nima Baradaran1, Tom F Lue1

  • 1Department of Urology, University of California San Francisco, San Francisco, CA, USA.

The Urologic Clinics of North America
|October 4, 2021
PubMed
Summary

Penile fracture is a urologic emergency diagnosed via history and physical exam. Surgical repair is preferred, and delayed surgery may yield similar outcomes to immediate intervention for this traumatic injury.

Keywords:
Collagenase clostridium histolyticumCorpus cavernosumPenile fracturePenile rupturePenile traumaUrethral injury

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Area of Science:

  • Urology
  • Trauma Surgery

Background:

  • Penile fracture is a rare but serious urologic injury.
  • Etiology of penile fracture varies globally.
  • Timely diagnosis and management are crucial for optimal patient outcomes.

Purpose of the Study:

  • To review the diagnosis and management of penile fracture.
  • To discuss the role of imaging in diagnosing penile fracture.
  • To compare outcomes of immediate versus delayed surgical repair.

Main Methods:

  • Review of existing literature on penile fracture.
  • Discussion of diagnostic tools including history, physical examination, retrograde urethrography (RUG), cystoscopy, ultrasound, and MRI.
  • Analysis of surgical versus conservative management strategies.
  • Evaluation of timing of surgical intervention.

Main Results:

  • Diagnosis is often achievable through history and physical examination alone.
  • Retrograde urethrography (RUG) or cystoscopy are indicated if urethral injury is suspected.
  • Ultrasound and MRI can aid in diagnosis and localization when clinical suspicion is high or diagnosis is uncertain.
  • Surgical management is generally favored over conservative treatment.
  • Delayed surgical repair may offer comparable outcomes to immediate intervention.

Conclusions:

  • Penile fracture requires prompt evaluation and management.
  • A combination of clinical assessment and imaging modalities ensures accurate diagnosis.
  • Surgical intervention is the mainstay of treatment, with delayed repair being a viable option.