Abstract
We present the case of a penile fracture involving the proximal corpus cavernosum, presenting as a hematoma extending into the scrotum. The presentation, diagnosis, and surgical approach, which differ from the more typical penile shaft fracture, are delineated.
Highlights
We present the case of a penile fracture involving the proximal corpus cavernosum, presenting as a hematoma extending into the scrotum
The deep scrotal and perineal tissues were explored through a midline perineal incision, where a large hematoma was encountered contained within ischiocavernosus muscle
Penile fracture is an underreported condition in which trauma to the erect penis, most often in the setting of sexual intercourse, tears the tunica albuginea and corpus cavernosum to produce a clinically evident hematoma that deforms and detumesces the erect penis
Summary
We present the case of a penile fracture involving the proximal corpus cavernosum, presenting as a hematoma extending into the scrotum. He continued to have painful erections since symptom onset and denied any obstructive or irritative voiding symptoms. His medical, surgical, family, and social history were unremarkable. Scrotal MRI was performed, which revealed a focal tear of the tunica albuginea overlying the right proximal corpus cavernosum. Associated with this was a 1 cm intracavernosal hematoma, as well as a 4 cm hematoma tracking anteriorly through the perineum toward the right hemiscrotum. After multiple rounds of copious irrigation, hemostasis was achieved and a right 1 cm oblique corporeal tear was visualized This was repaired primarily in a watertight fashion with interrupted figure-of-eight polydioxanone sutures (PDS). We left a penrose drain in the hematoma space and delivered it through a separate perineal stab wound incision
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