The role of ultrasound (US) and magnetic resonance imaging (MRI) in penile fracture mapping for modified surgical repair

Mehrjardi, Mohammad Zare; Darabi, Mohsen; Bagheri, Seyed Morteza; Kamali, Koorosh; Bijan, Bijan

doi:10.1007/s11255-017-1550-x

Cited by 33 publications

(36 citation statements)

References 18 publications

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“…A defect in the tunica albuginea, Buck fascia, or corpora should be described according to the side on which it is located and whether it is on the dorsal or ventral aspect of the penis . Its position along the penile shaft, whether proximal, mid, or distal, should also be conveyed and the length of the defect measured . A mark placed on the skin surface indicative of the fracture location can be helpful to the treating urologist.…”

Section: Ultrasound Techniquementioning

confidence: 99%

“…Likewise, when a haematoma is identified, its position on the side and aspect of the penis should be recorded as well as its size in three dimensions . A description as to whether it is intracavernosal or extracavernosal provides additional information . An example of schematic diagrams that can be utilised by the sonographer in demonstrating the location of pathology is illustrated in Figure .…”

Section: Ultrasound Techniquementioning

confidence: 99%

“…Because of the rarity of this entity, inexperienced operators are at a higher risk of missing subtle lesions, especially those obscured by haematoma and/or oedema . Furthermore, the presence of haematoma or swelling at the site of fracture can render the visualisation of a tunical tear difficult, especially if the defect is small in dimension …”

Section: Limitations and Pitfallsmentioning

confidence: 99%

“…A study conducted by Mehrjardi et al concluded that another significant limitation of ultrasound in displaying a true positive result was the location of the tunical defect. Fractures located at the base of the penis detected at magnetic resonance imaging (MRI) and surgical intervention had been an oversight by ultrasound examination in 12% of the sample volume …”

Section: Limitations and Pitfallsmentioning

confidence: 99%

“…23 Its position along the penile shaft, whether proximal, mid, or distal, should also be conveyed and the length of the defect measured. 24 A mark placed on the skin surface indicative of the fracture location can be helpful to the treating urologist. Likewise, when a haematoma is identified, its position on the side and aspect of the penis should be recorded as well as its size in three dimensions.…”

Section: Ultrasound Techniquementioning

confidence: 99%

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The role of ultrasound in the diagnosis of penile fracture

Napier

2018

Sonography

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Although considered a relatively rare occurrence, penile fracture is nonetheless a urological emergency. The importance of correctly identifying this pathology is essential when the long‐term sequelae of a delayed or misdiagnosis are considered. Due to the stigma attached to this entity, it is assumed that its true incidence remains underreported, and as such, literature on the sonographic evaluation of penile fracture is rendered to be relatively scarce. The consequence of such an unusual referral means that there is a gap in knowledge when it comes to attaining an accurate ultrasound diagnosis. This article will review the anatomy of the penis, the pathophysiology contributing to penile fracture, and how an inherent understanding of both is vital to the accurate sonographic grading of different fracture types. Although penile fracture is still considered a clinical diagnosis, ultrasound provides critical information in atypical or equivocal cases whereby multiple differential diagnoses cannot be excluded. The possibility of an incorrect diagnosis based on inconclusive historical and clinical findings therefore highlights not only the important role of ultrasound in the facilitation of prompt surgical intervention but also its contribution to a favourable patient outcome by way of correct management.

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Section: Ultrasound Techniquementioning

confidence: 99%

Section: Ultrasound Techniquementioning

confidence: 99%

Section: Limitations and Pitfallsmentioning

confidence: 99%

Section: Limitations and Pitfallsmentioning

confidence: 99%

Section: Ultrasound Techniquementioning

confidence: 99%

See 3 more Smart Citations

The role of ultrasound in the diagnosis of penile fracture

Napier

2018

Sonography

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Management of penile fracture with complete urethral transection in a resource‐limited setting: A case report

Médéus,

Saint Hubert,

Sinha

et al. 2024

Clinical Case Reports

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Key Clinical MessagePenile fracture is a urological emergency that requires prompt surgical intervention for optimal outcomes. Early diagnosis based on clinical presentation and imaging if needed is crucial. Timely repair ensures the preservation of penile function and minimizes complications.AbstractPenile fracture (PF) is a rare but significant urological emergency characterized by the rupture of the tunica albuginea, often resulting from blunt trauma during sexual intercourse or other activities. The typical presentation includes sudden and severe penile pain, an audible “cracking” sound followed by swelling and deformity. While PF generally does not involve the urethra, bleeding from the urethral meatus suggests an associated urethral lesion. Imaging such as ultrasonography or magnetic resonance imaging (MRI) can assess the extent of the injury. We report a case of a 28‐year‐old male who presented with sudden‐onset penile pain, swelling, and blood dripping from the urethral meatus after a traumatic sexual encounter. The injury occurred during vigorous intercourse when his erect penis struck his partner's buttocks. He heard a cracking sound followed by immediate detumescence, penile curvature, and urethral bleeding. At the hospital, the patient exhibited tachycardia and elevated blood pressure. Examination revealed deviation of the penis to the right, urethrorrhagia, and a tender, swollen penis. A clinical diagnosis of bilateral corpora cavernosa injury and partial rupture of the penile urethra was made. A urethral catheter was placed with difficulty, draining initially reddish urine followed by clear urine. Laboratory tests showed normal hemoglobin and coagulation profiles with mild bacteriuria and hematuria. Due to clear clinical signs, no radiological imaging was performed before surgery. Surgical exploration performed 48 h postinjury revealed a PF involving the right corpus cavernosum and a complete rupture of the spongy urethra. The corpus cavernosum was repaired using Vicryl 2–0 sutures followed by urethroplasty with Vicryl 5–0. Postoperative care included antibiotics and analgesics. The patient had an uneventful recovery with preserved penile sensitivity and function. PF is a rare urological emergency that necessitates prompt diagnosis and management to prevent long‐term complications. Although clinical presentation often suffices for diagnosis, imaging can be valuable in ambiguous cases. Surgical intervention is the preferred treatment, offering the best functional and cosmetic outcomes. This case underscores the importance of timely surgical repair to ensure favorable recovery and preservation of penile function.

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