Penile Fracture with Complete Urethral Rupture and Urine Extravasation: A Case Report

Penile fracture is a rare traumatic injury of an erect phallus involving mainly the tissues responsible for penile erection, corpora cavernosa, and penile sheath, which occur commonly, but not solely during vigorous sexual intercourse. Here, we present a 34-year-old man who presented with a 5-h history of snapping sound heard during sexual intercourse with subsequent loss of tumescence, swelling of the phallus, and assumption of abnormal contour, scrotal swelling, and lower anterior abdominal swelling. On examination, the patient was in severe painful distress with swelling around the external genitalia and lower abdomen and dorsolateral penile angulation with marked tenderness. The diagnosis of penile fracture was made; intraoperatively, there was a complete rupture of both corpora cavernosa and corpus spongiosum, complete disruption of the urethra, and buck's fascia tear causing haematoma and urine extravasation into the scrotum and anterior abdominal wall. The patient had haematoma evacuation, corpora repair, and urethroplasty done, did well, and has been on follow-up for 2 years with good erectile and voiding functions.