Penile Shaft Fracture

Basics

Description

  • Traumatic rupture of the corpus cavernosum and the encompassing tunica albuginea
  • May involve the corpus spongiosum and urethra
  • Hematoma formation occurs at rupture site
  • Injury is usually unilateral and transverse
  • Most common fracture site is the proximal shaft of the penis
  • During erection, pressure within the corpus cavernosum is maximal, close to arterial pressure, increasing the volume in each corpus to maximum, which thins the tunica albuginea, making it susceptible to rupture
  • Penile erection stretches the spongiosum to the limit, which limits movement vertically while allowing lateral movements; this forms a bend at the base of the penis, making it vulnerable to lateral swing and rupture of corpus cavernosum
  • 25–30% has associated urethral injury, which may be partial or complete
  • Caused by blunt trauma to erect penis during:
    • Sexual intercourse
    • Manipulation
    • Fall on erect penis
    • Entanglement in clothing
    • “Taqaandan” – Middle Eastern practice of forcefully bending the erect penis to cause detumescence

Etiology

  • Peyronie disease
  • Urethritis in past
  • Surgical procedure on corpus cavernosum or trauma to corpus cavernosum resulting in weak scar tissue

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