Clinical Observations in Penlie or Urethral Injuries during Penile Eection

Kim, Hyun Soo; Lee, Yun Kil; Oh, Tae Hee

Abstract

PURPOSE: Penile or urethral fractures are a rare urologic emergency that occur only during erection as a result of direct blunt trauma that vends the organ in an unphysiologic manner. We present our experiences in the management of 18 patients with penile or urethral injury sustained juring erection.
PATIENTS AND METHODS
Between January 1991 and June 1998, 18 patients were hospitalized for penile or urethral injury, rupture often as a result of sexual intercourse. They were managed by early surgical repair (N=10) or conservatively (N=8). Cavernosography was performed in 10 patients and urethrography in 2 patients. The patients ages at presentation ranged from 24 years to 54 years, with a mean of 35.9 years. The mean follow-up was 40.9 months (range 4 to 80).
RESULTS
Cavernosography showed extravasation of contrast medium in 4 patients. Surgical exploration in 10 patients revealed rupture of the tunica albuginea. Postoperative wound infection was observed in two patients but healed without late complication. All patients regained erectile potency, although penile curvature during erection that did not affect sexual activity was observed particularly in one patient who had received conservative treatment.
CONCLUSIONS
Surgical exploration is advocated particularly in the case of severe or expanding penile hematoma, severe penile deformity and rupture of turnica albuginea. Conservative treatment can be chosen only when the corporeal bodies are intact and there is neither signs of bleeding nor severe hematoma in the penis.