Microbubble-enhanced ultrasound to demonstrate urethral transection in a case of penile fracture

Czarnecki, Oliver; Stempel, Conrad Brice von; Sangster, Pippa; Walkden, Miles

doi:10.1136/bcr-2017-220073

Cited by 3 publications

(1 citation statement)

References 22 publications

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“…The authors emphasize advantages like more precise surgical planning and less extensive incision (15). Another case report describes a "microbubbleenhanced retrograde ultrasound urethrogram" that confirmed injury of the urethra avoiding radiation exposure of retrograde urethrography which is a standard procedure in inconclusive cases (16). Finally, both the intravenous or urethral application of ultrasound contrast agent (UCA) has not got achieved evidence so far.…”

Section: Patients Included In Statistcal Analysis (N=88)mentioning

confidence: 99%

Diagnostic performance of MRI and US in suspicion of penile fracture

Spiesecke¹,

Mang²,

Fischer³

et al. 2022

Transl Androl Urol

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Background: Penile fracture (PF) is defined as rupture of the tunica albuginea of the corpora cavernosa.While most authors agree that rapid surgical therapy of this rare pathology leads to the best patient outcome, the role of imaging is highly controversial in the published literature. To obtain further evidence concerning the diagnostic accuracies of magnetic resonance imaging (MRI) and ultrasound (US) in the diagnostic assessment of patients with suspected PF. Methods: We systematically reviewed MRI and US examinations performed in our institution between 2000 and 2021 and correlated imaging reports with either intraoperative finding or final clinical diagnosis. Inclusion criteria were: (I) patient age ≥18 years, (II) examination between 2000 and 2021, (III) information available on patient's history and clinical presentation, and (IV) documented final diagnosis in discharge letter. Next to diagnostic accuracy, we describe typical imaging findings such as penile hematoma, tear of the tunica albuginea including location in terms of side and shaft segment affected, and involvement of corpus spongiosum.Results: Overall, 46 of 88 included patients (54.5%) had a confirmed diagnosis of PF. A total of 69 MRI and 31 US examinations were included. Sensitivity and specificity were 91.9% (95% CI: 78.7-97.2%) and 90.6% (95% CI: 75.8-96.8%) for MRI and 71.4% (95% CI: 45.4-88.3%) and 100.0% (95% CI: 81.6-100.0%) for US, respectively. Conclusions:The results of the present study suggest that MRI is more suitable to confirm PF and identify the site of the associated tunica albuginea tear while US is a good tool for ruling out PF.

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Section: Patients Included In Statistcal Analysis (N=88)mentioning

confidence: 99%

Diagnostic performance of MRI and US in suspicion of penile fracture

Spiesecke¹,

Mang²,

Fischer³

et al. 2022

Transl Androl Urol

View full text Add to dashboard Cite

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Contrast-enhanced voiding urosonography part 2: urethral imaging

et al. 2021

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Utility of contrast enhanced ultrasound (CEUS) in penile trauma

Gómez-Bermejo,

Huang,

Bertolotto

et al. 2023

Insights Imaging

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Penile traumatic injuries are rare with potentially severe consequences, with clinical assessment challenging due to pain and swelling. Ultrasound is the primary imaging modality for assessing the penis. It has a high spatial resolution and rapid availability and is portable. Contrast enhanced ultrasound is an advanced ultrasound technique that adds real-time dynamic vascular imaging safely, increasing diagnostic precision and confidence, allowing for better therapeutic management of traumatic penile injuries. Contrast enhanced ultrasound helps to delineate the extent of a haematoma, distinguishing this from the herniated corpus cavernosum, detecting the point of rupture of the tunica albuginea, showing vascular abnormalities, localising a dislocated penis and determining penile viability. The integrity of the urethra may be assessed with intracavitary contrast enhanced ultrasound. Additionally, contrast enhanced ultrasound allows monitoring of the response to endovascular and surgical treatment. This review aims to detail the anatomy and pathogenesis of penile trauma, to give guidance on optimising the contrast enhanced ultrasound technique and to obtain diagnostic examinations. Illustration of the spectrum of aspects of penile trauma will be complemented with a literature review.Critical relevance statement Contrast enhanced ultrasound is a safe and efficient imaging modality that allows for highly accurate diagnoses, helping achieve more successful and conservative treatments of penile trauma complications.Key points• Ultrasound is an accurate and safe imaging test for penile trauma.• CEUS adds dynamic vascular imaging in real-time increasing diagnostic confidence.• CEUS can delineate penile haematomas, locate fractures and demonstrate vessel integrity.• CEUS potentially allows for more conservative treatment of penile trauma complications. Graphical Abstract

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Microbubble-enhanced ultrasound to demonstrate urethral transection in a case of penile fracture

Cited by 3 publications

References 22 publications

Diagnostic performance of MRI and US in suspicion of penile fracture

Diagnostic performance of MRI and US in suspicion of penile fracture

Contrast-enhanced voiding urosonography part 2: urethral imaging

Utility of contrast enhanced ultrasound (CEUS) in penile trauma

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