1/18/2024 0 Comments Penile fracture imaging![]() ![]() Mallen mentioned that “As general practitioners, we share cases with our clinical partners everyday and we learn from these informal experiences but we have no real tradition of publishing case reports”. ![]() ![]() It is unclear whether patients do not admit to primary care or primary care physicians missed diagnose or do not report penile fracture. There are several case reports or series from urology or emergency but not one from primary care. In our case, because of the delay, the patient and the urologist preferred conservative management.Īlthough it was reported that the fourth largest series in literature were from Turkey, this is the first case we had in our 17 years’ clinical experience in primary care. Immediate surgical reconstruction results in faster recovery, decreased morbidity, lower complication rates, and lower incidence of long term penile curvature. Suspected penile fractures should be promptly explored and surgically repaired. However, long term outcomes of conservative management demonstrated significant complication rates, such as curved or painful erections, erectile dysfunction, arteriovenous fistula formation, infection and plaque formation. The conservative management of penile fracture includes splinting, cold compresses, and a combination of anti-inflammatory, analgesic medications and fibrinolytics. Treatment may be either conservative or surgical. Another condition that may mimic penile fracture is rupture of the dorsal penile artery or vein during sexual intercourse. Physical examination may not be adequate for definitive diagnosis in these cases. After our explanation of the disease and necessity of immediate surgical treatment he accepted the history but he did not want to tell the details.įalse fracture has been reported in patients who present with penile swelling and ecchymosis, although they do not describe classic “snap-pop” or rapid detumescence typically associated with fracture. In our case, first the patient did not give any significant history probably due to embarrassment. Because fear and embarrassment are commonly associated the patient’s presentation to the health care professionals is sometimes significantly delayed. Penile rupture can usually be diagnosed based solely on history and physical examination findings however, in equivocal cases, diagnostic cavernosography or MRI should be performed. In the Middle East, self-inflicted fractures predominate. This includes masturbation, with or without devices falling out of bed with an erection extreme sexual activity, especially during coitus in which the female is on top forceful correction of a congenital chordee and even tucking an erect penis into underwear. Although penile fracture has been reported most commonly with sexual intercourse it can happen from any type of blunt trauma affecting the tumescent shaft. įracture typically occurs during vigorous sexual intercourse, when the rigid penis slips out of the vagina and strikes the perineum or pubic bone, sustaining a buckling injury. The patient usually describe a cracking or popping sound as tunica tears, followed by pain, rapid detumescence, and discoloration and swelling of penile shaft. The patient age ranges from 12 to 82 years with a mean age of mostly fourth decade. Penile fracture may present with classic “eggplant deformity” of swollen penis along with ecchymosis confined to Buck’s fascia. ![]()
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