A 22-year-old college student complains of penile pain and deformity. He states that 2 hours ago he was having intercourse when he noted a “snapping” sensation in his penis followed by localized pain and asymmetric swelling. You suspect a penile fracture. Which of the following statements is true?
The injury is due to a traumatic fracture of the corpus spongiosum and resulting hematoma formation.
+This injury is typically managed conservatively and rarely requires operative repair.
+A stat ultrasound should be obtained to evaluate the penile compartments.
+A Foley catheter should be immediately placed to prevent acute urinary retention.
+Of patients with this injury, a minority will experience a permanent deformity.
The penis consists of three main compartments: two corpora cavernosa and the corpus spongiosum. The corpora cavernosa comprise the main body of the penis while the corpus spongiosum lies on the ventral surface and contains the urethra and enlarges at the tip to form the glans penis. In a penile fracture, a traumatic tear of the tunica albuginea, most commonly during vigorous intercourse, leads to a subsequent rupture of the corpus cavernosum and penile hematoma. This injury is typically managed by operative hematoma evacuation, repair of the tunica albuginea, and placement of a pressure dressing. Up to 10% of all patients will experience permanent deformity, sexual dysfunction, and impaired erections. Nonsurgical treatment with bed rest, ice, and pressure dressing may be tried, but is associated with increased rates of complication. Patients will be able to void if there is no injury to the urethra.