Complete Urethral Disruption Research Articles

Double penile fracture with complete urethral disruption following anal intercourse: a case report

Penile fracture remains a rare, under reported condition. It is defined as blunt trauma resulting in tear of tunica albuginea surrounding the corpus cavernosum during erection. Prompt diagnosis and early surgical repair are essential. Here we report a case of 37 years male with penile fracture involving both corpora cavernosum and complete urethral disruption. A 37-year-old man presented with penile injury during anal intercourse. Physical examination revealed a swollen, ecchymotic penis with dorsal angulation. Penile ultrasound showed tear in bilateral corpora cavernosa at ventral aspect with hematoma. On exploration tear in bilateral corpora with complete penile urethral disruption seen. Repair of corporal tear with end to end anastomotic urethroplasty done. He has normal voiding and sexual function at 4th months of follow up. The diagnosis of this condition is clinical, which is further augmented by high frequency sonography, which can detect exact site of the tear, also allows evaluation of penile vascularity. Evaluation of the urethra with sonography can help identify interruption of the urethral wall. As in our patient, double fracture involving corpora cavesnosa of both sides with complete urethral disruption, is rare entity. Urgent surgery with complete penile degloving is advocated and extreme care is needed not to miss any injury. Fracture of the penis is a rare surgical emergency. The diagnosis is clinical, however high-resolution sonography and colour Doppler are helpful. Early and prompt surgical intervention can restore normal voiding and erectile function to lead a healthy life.

Straddle injuries to the bulbar urethra: What is the best choice for immediate management?

Cystostomy, endoscopic realignment, and emergency anastomosis are three methods used to treat bulbous urethral injury (BUI). The aim of the study is to determine the optimal management. A retrospective study was performed on 328 male patients with blunt straddle injury to the perineum. In total, 304 patients were included in the analysis due to strict criteria. Among these 304 patients, 197 had partial urethral disruption diagnosed, and 107 had complete urethral disruption. Group placement of the patients was based on the extent of injury. Each group was further divided into two subgroups based on the immediate management. Propensity score matching was used to correct for differences in baseline characteristics. In the partial disruption group, the propensity score-matched subgroups set comprised of 164 patients. Of the 82 patients treated with endoscopic realignment, 34 (41.5%) patients required no urethral surgery, in contrast to 12 (14.6%) patients with cystostomy (p < 0.05). No significant difference was found in the other respects (p > 0.05). In the complete disruption group, the propensity score-matched subgroups set comprised of 104 patients. The success rate of emergency anastomosis was 90.4% (47 patients), and urethral stricture occurred in five patients (96%), while urethral stricture developed in all 52 patients in the cystostomy subgroup. With regard to surgical management of complications, the choice of management methods significantly differed between the two subgroups (all, p < 0.05). The time to natural urination and duration of hospital stay were significantly shorter in the emergency anastomosis subgroup (29.1 ± 5.4 days vs. 57.1 ± 6.4 days; 7.2 ± 3.1 days vs. 12.5 ± 2.3 days; each p < 0.05). Endoscopic realignment is associated with a lower stricture rate than cystostomy as immediate management for partial disruption. Emergency anastomosis provides better clinical outcomes for patients with complete disruption. Therapeutic Level IV.

An American Association for the Surgery of Trauma (AAST) prospective multi-center research protocol: outcomes of urethral realignment versus suprapubic cystostomy after pelvic fracture urethral injury.

BackgroundPelvic fracture urethral injuries (PFUI) occur in up to 10% of pelvic fractures. It remains controversial whether initial primary urethral realignment (PR) after PFUI decreases the incidence of urethral obstruction and the need for subsequent urethral procedures. We present methodology for a prospective cohort study analyzing the outcomes of PR versus suprapubic cystostomy tube (SPT) after PFUI.MethodsA prospective cohort trial was designed to compare outcomes between PR (group 1) and SPT placement (group 2). Centers are assigned to a group upon entry into the study. All patients will undergo retrograde attempted catheter placement; if this fails a cystoscopy exam is done to confirm a complete urethral disruption and attempt at gentle retrograde catheter placement. If catheter placement fails, group 1 will undergo urethral realignment and group 2 will undergo SPT. The primary outcome measure will be the rate of urethral obstruction preventing atraumatic passage of a flexible cystoscope. Secondary outcome measures include: subsequent urethral interventions, post-injury complications, urethroplasty complexity, erectile dysfunction (ED) and urinary incontinence rates.ResultsPrior studies demonstrate PR is associated with a 15% to 50% reduction in urethral obstruction. Ninety-six men (48 per treatment group) are required to detect a 15% treatment effect (80% power, 0.05 significance level, 20% loss to follow up/death rate). Busy trauma centers treat complete PFUI approximately 1–6 times per year, thus our goal is to recruit 25 trauma centers and enroll patients for 3 years with a goal of 100 or more total patients with complete urethral disruption.ConclusionsThe proposed prospective multi-institutional cohort study should determine the utility of acute urethral realignment after PFUI.

Penile fracture; three years’ experience from a tertiary care centre

Background: To study cause, presentation, diagnosis and early management of penile fracture and to prevent the complications.Methods: In this study 48 patients of penile fracture were included in the study who were admitted in general surgery department at Government Medical College Srinagar from May 2007 to May 2010. All patients were evaluated with detailed history, clinical examination and baseline investigations followed by immediate surgical repair.Results: Age range of patients was 21-75 years. Youngest being 21 years and eldest being 75 years (median-30 years). 38(79.1%) patients were married while as 10(20.9%) patients were unmarried. Sexual intercourse was main cause, seen in 41(85.4%) of patients, aggressive masturbation in 5(10.4%) patients and rolling over in bed during erection was seen in 3(6.2%) patients. All patients presented in general surgery department with complaints of pain and swelling in penile region. Time interval between injury and presentation to the department ranged from 4-24 hours (mean 11 hours). Isolated cavernosa injury was seen in 43 (89.6%) patients, while as 5 (10.4%) patients were having associated urethral injury (3 were having partial injury and 2 complete urethral disruption). There was a ventral rent in 31(64.6%) patients and lateral rent in17 (35.4%). Size of tear in tunica albuginea was less than 1cms in 19(39.6%) patients, 1-2cm in 17(35.4) patients and more than 2cms in 12 (25%) patients. Patients were discharged on 2-5 days (mean 3.1 days). There were no immediate postoperative complications. 2 (4.1%) patients had pricking sensation at repair site, 1(2.05%) patient had pain during erection and 2 (4.01%) patients had mild deviation during erection on follow up.Conclusions: Penile fracture is a relatively rare urological emergency which mostly occurs during sexual intercourse or aggressive masturbation and is usually a clinical diagnosis. Early surgical repair avoids complications and preserves both sexual and voiding functions.

P-01-055 Penile fracture with complete urethral rupture in 29 years old male. Primary delayed surgical repair

Penile fracture is often accompanied by various forms of urethral trauma. Even though the gold standard is immediate surgical repair, delayed repair is possible and has comparable outcome when performed in specialized centres. Our goal is to present the surgical repair of a fractured penis with complete urethral rupture, 7 days after the trauma occurred. A 29 years old male was admitted to the Urological department with 7 days history of sudden cracking sound followed by severe pain and swallowing of the penis, which occurred during sexual intercourse. The patient was first admitted to another hospital where a suprapubic catheter was placed following unsuccessful placement of a Foley catheter. The patient had severe contusion localized in penile shaft, clearly contained by Buck’s fascia. Ultrasound evaluation revealed a discontinuation of tunica albuginea and blurring of the surrounding tissues, due to a hematoma. The patient underwent an urethrography where a mass extravasation of the contrast mean was demonstrated. Therefore he was lead to the operating theater where he underwent penis deglovement. After the hematoma was removed, a complete urethral disruption was revealed, at the level of penile urethra, along with tunica’s albuginea of both corpora cavernosa. What followed was suturing of tunica’s disruption and repairing of the urethral defect using buccal mucosa after the positioning of a 16 Fr Foley catheter.

Case of Penile Fracture Revealing Bilateral Corporal Cavernosal Tears and Complete Urethral Disruption

Case of Penile Fracture Revealing Bilateral Corporal Cavernosal Tears and Complete Urethral Disruption

Urinary and sexual functions after surgical treatment of penile fracture concomitant with complete urethral disruption

Penile fracture with concomitant complete urethral disruption is an uncommon urologic disorder. Data about the treatment and outcome measurements of this condition are scarce in the literature. The aim of the present study is to evaluate the long term urinary and sexual functions of patients with penile fracture associated with complete urethral injury after immediate surgical reconstruction. Twelve patients met our inclusion criteria and were included in this retrospective case series study; however, one was lost during follow-up. Patient's medical records were reviewed and all patients were interviewed for clinical evaluation. Urinary function was assessed by history, uroflometry and retrograde urethrography, while, sexual function was assessed by questionnaire (Sexual Health Inventory for Men) and penile Doppler for patients with erectile dysfunction. Patients' mean age was 32.3 ± 7.5 years (range 21-43) and the mean follow-up period was 72.6 ± 45.4 months (range 14-187). Vigorous sexual intercourse was the main cause in 91% of our patients. No serious long term complications was found. Only 1 patient (9%) suffered from anterior urethral stricture, 1 patient (9%) complained of weak erection, 3 patients (27%) had a palpable fibrosis and 2 patients (18%) reported a slight penile curvature during erection. Ninety one percent of all our patients maintained their normal urinary and sexual functions. On the long term follow-up, most of the patients maintained their normal erectile and voiding functions with no harmful long-term complications. We advocate immediate surgical intervention and reconstruction of both corpora cavernous and urethra as a first line treatment for those patients.

V1-14 REPAIR OF COMPLETE URETHRAL DISRUPTION DUE TO SYNTHETIC SLING COMPLICATION

You have accessJournal of UrologyFemale Pelvic Medicine & Reconstructive Surgery1 Apr 2014V1-14 REPAIR OF COMPLETE URETHRAL DISRUPTION DUE TO SYNTHETIC SLING COMPLICATION Nitya Abraham and Sandip Vasavada Nitya AbrahamNitya Abraham More articles by this author and Sandip VasavadaSandip Vasavada More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.608AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Urethral complications due to synthetic mid-urethral slings are rare. Possible causes may include unrecognized trocar injury, mesh implantation despite recognized injury, mesh contamination leading to inflammation and delayed perforation, and excessive sling tension. There is no consensus as to the surgical management of urethral complications with regard to how much mesh should be excised, whether an interposition flap should be utilized, and whether a pubovaginal sling should be placed at the time of surgery. We present a case of complete urethral disruption due to a synthetic mid-urethral sling complication. METHODS A 56 year old woman was referred for a hole in her urethra. She reported mixed urinary incontinence requiring 6 pads per day. She denied continuous incontinence, split stream, or recurrent UTI. Her surgical history was significant for prolapse repair and synthetic transobturator sling surgery complicated by synthetic sling extrusion with subsequent sling revision. Physical exam revealed complete urethral distraction distal to the bladder neck. The proximal urethral segment was about 2 cm in length and the distal urethral segment about 1 cm in length. The patient also had stage 3 pelvic organ prolapse. Cystoscopy confirmed that the urethral distraction was distal to the urethral sphincter. The bladder was normal. RESULTS The patient was counseled regarding surgical repair of the complete urethral distraction. A primary end-to-end urethral reconstruction was performed. Any residual synthetic mesh was excised. Given the good tissue quality and water-tight closure, we did not place an interposition flap. We also opted not to address her stress incontinence with concomitant fascial sling placement as we did not want to compromise the urethral repair. VCUG was performed after 3 weeks revealing no extravasation. The foley catheter was removed. On follow-up the patient reports bothersome urgency incontinence. She denies stress urinary incontinence. CONCLUSIONS Complete urethral disruption is a rare complication of synthetic mid-urethral sling surgery, that can be repaired primarily with good results. There is no consensus regarding the surgical management of such complications and thus an individualized approach should be used based on the patient’s presentation and surgeon expertise. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e295 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Nitya Abraham More articles by this author Sandip Vasavada More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Penile fracture with bilateral corporeal rupture and complete urethral disruption: case report and literature review

Penile fracture is a rare injury most commonly sustained duringsexual intercourse. We report the case of a 35-year-old man whopresented with bilateral rupture of the corpora cavernosa andcomplete disruption of the urethra. A review of the literature onpenile fracture is also presented. Urgent surgical exploration wasperformed and the injuries repaired primarily. In follow-up, thepatient reported satisfactory erectile function. This case highlightsthe importance of early surgical repair and evaluation for concomitanturethral injuries in cases of penile fracture.

The initial management of complete urethral disruption in a deployed military field hospital

BackgroundThe management of male urethral trauma in the multiply injured battle casualty has proved challenging to the deployed military trauma surgeon. Foreign nationals will need culturally sensitive outcomes with adequate urinary function when further surgical management is unlikely to be available in a developing country. For those likely to undergo reconstructive surgery, the early restoration of anatomy is important as it may improve the long-term reconstructive outcome. MethodWe illustrate our technique with a case report and discuss salient points of other patients treated in the same manner, all of whom presented to a role 2 (enhanced) field hospital in Afghanistan with urethral injuries. ResultsA transpelvic high velocity gunshot wounds (HVGSW) was sustained and the patient underwent immediate anatomical re-alignment of the urethra with suture of the bladder neck to the pelvic floor. This case is discussed in detail. ConclusionsComplete disruption of the male urethra can be successfully managed in the field hospital by urethral catheterization at the time of initial surgery. In patients where further reconstruction may not be possible, urethral catheterization provides a culturally permissible solution for patients. In those who may undergo further reconstructive surgery, approximation of the bladder to the pelvic floor may reduce stricture rate in comparison with the suprapubic catheterization alone.

Outcomes of Endoscopic Realignment of Pelvic Fracture Associated Urethral Injuries at a Level 1 Trauma Center

We examined the success of early endoscopic realignment of pelvic fracture associated urethral injury after blunt pelvic trauma. A retrospective review was performed of patients with pelvic fracture associated urethral injury who underwent early endoscopic realignment using a retrograde or retrograde/antegrade approach from 2004 to 2010 at a Level 1 trauma center. Followup consisted of uroflowmetry, post-void residual and cystoscopic evaluation. Failure of early endoscopic realignment was defined as patients requiring urethral dilation, direct vision internal urethrotomy, posterior urethroplasty or self-catheterization after initial urethral catheter removal. A total of 19 consecutive patients (mean age 38 years) with blunt pelvic fracture associated urethral injury underwent early endoscopic realignment. Twelve cases of complete urethral disruption, 4 of incomplete disruption and 3 of indeterminate status were noted. Mean time to realignment was 2 days and mean duration of urethral catheterization after realignment was 53 days. One patient was lost to followup after early endoscopic realignment. Using an intent to treat analysis early endoscopic realignment failed in 15 of 19 patients (78.9%). Mean time to early endoscopic realignment failure after catheter removal was 79 days. The cases of early endoscopic realignment failure were managed with posterior urethroplasty (8), direct vision internal urethrotomy (3) and direct vision internal urethrotomy followed by posterior urethroplasty (3). Mean followup for the 4 patients considered to have undergone successful early endoscopic realignment was 2.1 years. Early endoscopic realignment after blunt pelvic fracture associated urethral injury results in high rates of symptomatic urethral stricture requiring further operative treatment. Close followup after initial catheter removal is warranted, as the mean time to failure after early endoscopic realignment was 79 days in our cohort.

Penile fracture with bilateral rupture in tunica albuginea and complete urethral disruption: A case report with review of literature

Penile fracture is a rare emergent condition, which includes rupture of the tunica albuginea of corpus cavernosum that occurs after trauma to the erect penis. The true incidence of penile fracture is not known as it is rare and under reported entity. Bilateral rupture of tunica albuginea with complete urethral disruption is very rare and very few cases were reported. We report a case of a 46-year-old man who presented with acute pain and swelling of penis and hematuria and severe burning pain during micturition, after a blunt trauma during sexual intercourse. Magnetic resonance imaging (MRI) revealed bilateral rupture in tunica albuginea and complete urethral disruption. We have done emergency repair of tunica and urethra suturing over a catheter. Postoperatively, patient regained normal erectile and voiding functions.

Complete urethrovesical disruption following obstructed labor

A 22-years-old lady presented with obstructed labor with a probable preoperative diagnosis of bladder/urethral injury. When a laparotomy was performed there was a complete urethral disruption at the vesicourethral junction with a big anterior forniceal tear in the vagina with intact uterus and cervix. The fetus had pushed itself through the upper vagina and bladder neck into the extraperitoneal space leading to complete urethrovesical disruption as a result of prolonged pressure on the vesicourethral junction against pubic symphysis for which an end to end anastomosis was performed. Although trauma has been mentioned as a cause of such urethral disruption in the literature, no such case has been reported so far following obstructed labor. A brief discussion of various surgical options for such cases is discussed.

Penile fracture with bilateral corporeal rupture and complete urethral disruption: case report and literature review

Penile fracture is a rare injury most commonly sustained during sexual intercourse. We report the case of a 35-year-old man who presented with bilateral rupture of the corpora cavernosa and complete disruption of the urethra. A review of the literature on penile fracture is also presented. Urgent surgical exploration was performed and the injuries repaired primarily. In follow-up, the patient reported satisfactory erectile function. This case highlights the importance of early surgical repair and evaluation for concomitant urethral injuries in cases of penile fracture.

10 OUTCOMES OF ENDOSCOPIC REALIGNMENT OF POSTERIOR URETHRAL INJURIES AT A LEVEL 1 TRAUMA CENTER

You have accessJournal of UrologyTrauma/Reconstruction: Trauma & Reconstructive Surgery1 Apr 201110 OUTCOMES OF ENDOSCOPIC REALIGNMENT OF POSTERIOR URETHRAL INJURIES AT A LEVEL 1 TRAUMA CENTER Laura Leddy, Hunter Wessells, and Bryan Voelzke Laura LeddyLaura Leddy Seattle, WA More articles by this author , Hunter WessellsHunter Wessells Seattle, WA More articles by this author , and Bryan VoelzkeBryan Voelzke Seattle, WA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.071AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES We sought to examine the success of initial endoscopic realignment following blunt pelvic trauma. METHODS A retrospective review was performed of all patients with pelvic fracture urethral disruption defect (PFUDD) who underwent endoscopic realignment from 2004–2010 at a Level 1 trauma center. Retrograde urethrogram, flexible cystoscopy, and clinical suspicion aided diagnosis of PFUDD. Endoscopic realignment of the posterior urethra was performed when the patient was clinically stable. Subsequent need for urethral dilation, internal urethrotomy, posterior urethroplasty, or intermittent self-catheterization following urethral catheter removal was considered failure. Uroflowmetry, postvoid residual and cystoscopic evaluation were utilized to diagnose failure of endoscopic realignment. RESULTS Nineteen patients with PFUDD who underwent endoscopic realignment were identified. Mean age was 38 (median 36). Injury etiology included the following: 10 motor vehicle crashes, 4 crush injuries, 3 vehicle vs. pedestrian accidents, 1 snowboarding accident, and 1 motorcycle crash. The following posterior urethral injuries were identified during endoscopic realignment: 12 complete urethral disruptions, 4 incomplete disruptions, 3 unable to determine. Mean time from injury to endoscopic realignment was 2 days (range 0–7 days). Mean duration of urethral catheterization following endoscopic realignment was 53 days (range 12–87 days). Fourteen of 19 patients failed initial endoscopic realignment. One patient was lost to follow up. Mean time to identification of failure following initial urethral catheter removal was 79 days (range 0–288 days). The following interventions were performed among the endoscopic realignment failures: posterior urethroplasty (11) and DVIU (3). Mean follow up for the remaining 4 patients considered to have undergone successful endoscopic realignment is 565 days (range 109–939 days). Findings identified at the time of endoscopic realignment in patients treated successfully with this technique included: complete disruption (2), 2cm dorsal bulbar laceration (1), vertical laceration at bladder neck (1). CONCLUSIONS Primary endoscopic urethral realignment following PFUDD results in high rates of symptomatic urethral stricture requiring further operative treatment. Close follow up after initial catheter removal is warranted. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e4 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Laura Leddy Seattle, WA More articles by this author Hunter Wessells Seattle, WA More articles by this author Bryan Voelzke Seattle, WA More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Delayed retropubic urethroplasty of completely transected urethra associated with pelvic fracture in girls.

The objective of the present study was to evaluate the results and the complications of delayed retropubic urethroplasty of completely transected urethra associated with pelvic fracture in girls. From 2002 to 2008, a total of 7 girls with complete urethral disruption after pelvic fracture were referred to our center and all of them underwent delayed retropubic urethroplasty with end-to-end anastomosis of the urethra. Seven female patients with a median age of 6 years old underwent delayed end-to-end anastomosis. The median time to surgery was 6 months from the trauma. Voiding was normal after catheter removal in all of the patients. The median follow-up was 36 months. Three patients had mild stress urinary incontinence after catheter removal. There are some different strategies for management of complete urethral avulsion in females who have sustained pelvic fracture, including early realignment, bladder flaps, and end-to-end anastomosis. The strategy of delayed end-to-end anastomosis urethroplasty with retropubic approach is sound and produces acceptable results. The use of flexible cystoscope and omental flap is effective in achieving continence after urethroplasty in such cases.

Management of extended penile trauma with bilateral rupture of cavernosal bodies and complete urethral disruption

Management of extended penile trauma with bilateral rupture of cavernosal bodies and complete urethral disruption

Proposed mechanisms of lower urinary tract injury in fractures of the pelvic ring

To investigate whether the observation of particular pelvic fracture patterns enables the clinician to predict the presence and type of injuries to the lower urinary tract, as the mechanisms of injury to the lower urinary tract in association with fractures of the pelvic ring are unclear. The case-notes and radiographs of 168 patients with either pelvic ring or acetabular fractures were reviewed; 108 pelvic ring fractures (81 men, 27 women) and 60 acetabular fractures (46 men, 14 women). The pelvic fractures were classified according to the system described by Tile and were correlated with the incidence and type of lower urinary tract injury (LUTI). Overall, of the 108 men and women with pelvic ring fractures, 27 (25%) had a LUTI documented either radiologically or as an intraoperative finding. Of the 81 men with pelvic ring fractures, 24 (30%) had a LUTI, of whom six (7%) had an isolated bladder laceration, 14 (17%) a partial urethral injury (PUI) and four (5%) a complete urethral disruption (CUD). Five of the 18 men with urethral injuries also had bladder injuries and in three of these, the bladder neck was also injured. Three of 27 women (11%) had a LUTI, all of whom had isolated bladder lacerations. Of the 46 men with an acetabular fracture, one (2%) had a CUD, and three (7%) had a PUI. One of 14 of women with an acetabular fracture sustained a bladder laceration. None of the three men with a Tile Type-A pelvic ring fracture sustained a LUTI. Of the 28 men with 'open-book' (Tile Type-B1) fractures, 21 (75%) had no associated LUTI and seven (25%) had a LUTI (five partial urethral injuries and two bladder lacerations). Of the 10 men with 'lateral compression' (Tile Type-B2) fractures, six had no LUTI and four had a LUTI (two partial urethral injuries and two bladder lacerations). Of the 40 men with 'vertical shear' (Tile Type-C) fractures, 27 (68%) had no LUTI and 13 (32%) a LUTI (four complete urethral disruptions, seven partial urethral injuries, and two bladder lacerations) including all of the combined bladder and urethral injuries and all of the bladder neck injuries. The pelvic fracture pattern alone does not predict the presence of a LUTI. When it occurs, the type of LUTI appears to be related to the fracture mechanism. The pattern of injury to the soft tissue envelope and specifically to the ligaments supporting the lower urinary tract offers the best correlation with the observed LUTI. We propose a mechanism for this.

A case of penile fracture with complete urethral disruption during sexual intercourse: a case report

Penile fracture is a rare condition. Primarily it is a rupture of the corpus cavernosum that occurs when the penis is erect. The rupture can also affect the corpus spongiosum and the urethra.We report a case of a 37 year old man who presented with acute penile pain, penile swelling and the inability to pass urine after a blunt trauma during sexual intercourse. In emergency surgery we found bilateral partial rupture of the corpus cavernosum with complete urethral and corpus spongiosum disruption. In the one year follow up the patient presented with normal erectile and voiding function.Emergency surgical repair in penile fracture can preserve erectile and voiding function.

Erectile dysfunction after fracture of the pelvis

Male sexual dysfunction after fracture of the pelvis is more common than previously supposed with rates as high as 30% reported when the complaint is specifically sought. With the increase in survival from major injuries, the long-term consequences of trauma are being seen with increasing frequency