The combination of lesions of the penile urethra and the corpus cavernosum is rare and likely to go unremarked. It worsens the immediate and long-term prognosis and poses a problem of management. Among 312 cases of penile fracture, we performed a retrospective study of a series of 10-case of traumatic corpora cavernosa rupture complicated with urethral rupture, treated in the department of Urology at 'Charles Nicolle' Hospital in Tunis. The median patients' age was 30 years. The most common mechanism was manipulation of an erect penis, found in six cases. Urethral rupture was suspected in all patients given the presence of bloody urethral discharge. No preoperative radiographic investigations were necessary. All patients underwent immediate surgical exploration. The urethral injury was always partial and localized at the level of the corpora tear. Surgical repair of both urethral and corpora tear was done in all patients. The follow up was uneventful. Urethrography at the removal of the transurethral catheter did not visualize contrast extravasation in any patient. No urethral stricture or erectile complaints were noted within a 36-month mean follow-up. Urethral rupture must be suspected in any case of penile fracture presenting with bloody urethral discharge. Standard treatment is immediate surgical repair.
Le carcinome épidermoïde de l’urètre masculin est une tumeurrare, les tumeurs de l’urètre tous types confondus représentantmoins de 1 % des tumeurs de l’appareil urinaire. Le pronosticreste défavorable malgré un traitement chirurgical énergique. Laradiochimiothérapie semble être un traitement prometteur, maisson rôle doit être défini par d’autres études.Nous rapportons un cas rare de carcinome épidermoïde del’urètre bulbo-membraneux découvert à un stade localement avancéaprès observation d’une rupture urétrale transtumorale chez unhomme âgé de 70 ans. Le patient a été traité, après drainage vésical,par une irradiation externe associée à une chimiothérapie parcisplatine, et est décédé après progression de la maladie sur un an.La rupture spontanée de l’urètre transtumorale est un modede découverte exceptionnel témoignant d’une évolution localedéfavorable, ce qui rend ces tumeurs difficilement opérables.Cependant, l’espoir actuel réside dans des protocoles thérapeutiquesassociant radiothérapie et chimiothérapie.
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