Penile Fracture and Associated Urethral Injury

Fracture of the penis is an uncommon pathology. It consists in a rupture of the tunica albuginea of one or both corpora cavernosa following injury to an erect penis. The most common causes are blunt trauma during sexual intercourse, masturbation, unconscious nocturnal penile manipulation or a fall onto the erect penis. The reason why rupture of the albuginea occurs only during erection lies in the fact that in the normal flaccid condition the penis occupies a position which is well protected against blows or blunt traumas. In the erect penis the tunica albuginea thins from 2 mm to 0.5 0.25 mm and thus it is more susceptible to traumatic tearing. Penile fracture associated with urethral injury is even more uncommon and accounts for 10 to 20% of reported cases. Prompt diagnosis and immediate surgical repair allows for earlier resumption of sexual activity and gives a lower incidence of penile chordee secondary to blood clot absorption and fibrous tissue formation. Surgery is mandatory for the prevention of late sequelae following injury especially in cases associated with urethral rupture. At times the corporeal tear is very large and in patients with concomitant lesions involving the urethra surgical repair can become difficult and require particular technical shrewdness. We report the surgical repair of 8 cases of penile fracture, two of which were complex involving both corpora cavernosa and an associated partial rupture of the urethra.