Penile fracture
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Synopsis
The classic presentation of penile fracture is a patient with a history of blunt trauma to the penis followed by an audible "pop" or "snap," accompanied by pain, swelling, discoloration, and rapid detumescence.
Physical examination will almost always reveal a hematoma. If Buck's fascia is intact, a local hematoma can accumulate, resulting in an "eggplant deformity." If Buck's fascia is disrupted, the hematoma can extend into the scrotum, perineum, or suprapubic regions. The penis may deviate to one side. Patients with concomitant urethral injuries may present with gross hematuria, blood at the urethral meatus, or inability to void.
A defect in the tunica albuginea may be palpated along the shaft of the penis, which is known as the "rolling sign."
Penile fracture is a clinical diagnosis based on the typical history and physical examination; however, if these are equivocal, penile ultrasound or MRI can be helpful.
Suspected penile fracture should be managed with prompt urologic referral and urgent surgical repair. Urethroscopy or retrograde urethrogram should be considered to evaluate for concomitant urethral injury and is required in patients with gross hematuria, blood at the urethral meatus, or inability to void.
While injuries to the genital region are seldom life-threatening, it is crucial to promptly diagnose and assess them to reduce the risk of potential long-term health complications.
Codes
S39.840A – Fracture of corpus cavernosum penis, initial encounter
SNOMEDCT:
110016007 – Penile fracture
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Last Updated:11/06/2023