Patients usually present complaining of trauma during sexual arousal and often relate a sudden “snapping” sound or sensation, pain, and deformity, which is caused by a tearing of the tunica albuginea. The shaft of the penis is swollen and often angulated at the fracture site (called “eggplant deformity”).
Management and Disposition
If the patient cannot urinate, obtain a retrograde urethrogram to rule out urethral injury. Obtain urologic consultation as patients are frequently taken immediately to the operating room for repair.
Patients sometimes concoct elaborate stories that are not sexually related surrounding the circumstances of injury, but penile fracture most commonly occurs during sexual arousal.
Penile implants are also subject to injury in a similar fashion.
Penile fracture. Penile fracture with ecchymosis and angulation. (Photo contributor: Stephen W. Corbett, MD.)
Penile fracture. Penile fracture with ecchymosis and edema without angulation. (Photo contributor: Emergency Medicine Department, Naval Medical Center Portsmouth, VA.)
Penile Fracture. A penile fracture showing classic “eggplant deformity.” (Reproduced with permission from Cooper B, Beres K. Penile fracture. J Emerg Med. 2017;52(2):238-239. © Elsevier Inc. 2016.)