Introduction Penile fracture is a well-recognized clinical entity. It is relatively uncommon and is considered a urological emergency. Its management has been a subject of controversy. Aim In this article, we will review contemporary knowledge of the epidemiology, pathophysiology, evaluation, and evolving management strategies of penile fracture. Methods A case report was discussed followed by an English-language Medline review. Main Outcome Measure Review of the available literature to establish best-practice management. Results The injury is defined as the traumatic rupture of the corpus cavernosum secondary to a blunt trauma of the erect penis. The condition is underreported. The commonest causes were coital injuries and penile manipulation. The diagnosis was usually fairly straightforward because of the stereotypical clinical presentation. Associated injuries included urethral rupture. Imaging was helpful in selected cases. Conservative measures were associated with increased complications. Most authors advocated early surgical repair. False explorations have been reported. Conclusions Penile fracture is a clinical diagnosis. The ideal management has evolved and remains largely surgical. Preoperative imaging should not delay surgical repair.

The three evaluated scoring systems have similar predictive accuracy of SFR. S.T.O.N.E. has additional value in predicting OT. Risk group stratification can be used for patient counseling. Further research is needed to identify whether or not any is superior to the others with regard to clinical usefulness and predictive accuracy.

DCE-CT imaging with quantitative CT perfusion analysis could be useful for detecting coronary stenoses that are functionally significant.

By measuring stent position, we were able to quantify the range of motion of the ureter during changes in body position. Stent movement appears to be a combination of bowing in the proximal ureter and moving within the bladder. Future stent designs may take this into account to decrease stent-related symptoms.