Lesion of the urethra and corpus spongiosum in the event of a misstep of the coitus without fracture of the corpus cavernosum: About one case

Abstract

Introduction Traumatic lesions of the anterior urethra during coitus strikes are essentially described as lesions associated with 20 percent of corpus cavernosum fractures. However, no cases of isolated lesions of the urethra and corpus spongiosum in the context of sexual trauma seem to be reported in the literature. Thus, we report the observation of a patient who was diagnosed with a corpus spongiosum fracture associated with a penile urethra injury during a coitus lapse. Presentation of case Patient aged 36 years with no particular pathological history, other than unprotected sexual intercourse, who has been admitted to the urology service for urethrorrhagia due to a sexual traumatism. A forced angulation and then a cracking followed by an instantaneous detumescence was described by the patient. On examination we noted a normal-looking penis without angulation or eggplant haematoma, with the presence on palpation of a small infra-centimetric hematoma on the ventral surface of the middle part of the penis. Surgical exploration was therefore indicated in front of the isolated urethrorrhagia, and which objectified a fracture of the corpus spongiosum measuring 1 cm at the level of the distal part of the penis. A linear lesion of the urethra was associated at the same level. The patient was therefore sutured with these two lesions. The postoperative course was simple with removal of the bladder catheter three weeks later with satisfactory urination and urinary stream. Discussion sexual trauma is described as a rupture of the corpora cavernosa, resulting from forced flexion or twisting of the erect penis that can be associated in about 20 % of cases with ruptures of the urethra. We described a trauma occurrence that is similar to the one in the definition responsible of a lesion of the anterior urethra but no lesions of the corpora cavernosa have been objectified. Conclusion the absence of similar cases reported in the literature leaves this type of lesion subject to ambiguous behaviour. Indeed, this brings us back to questions about the pathophysiological mechanisms of sexual lesions of the urethra in order to better codify the indication for surgical exploration, even in front of a normal looking penis.

Isolated rupture of the corpus spongiosum with urethral injury diagnosed by pre‐surgical MRI

“…Our patient had a ruptured CS with a urethral tear but without injury of the CC. The mechanism of this isolated injury is unknown 3 …”

“…The mechanism of this isolated injury is unknown. 3 The diagnosis of PF can usually be made by history and physical examination; patients report a cracking sound, and there is pain, swelling, and visible hematoma of the penis. Rapid surgical management is required for suspected PF, especially when urethral injury is likely.…”