Tri‐tubular penile fracture: A case of complete rupture of urethra and bilateral corpus cavernosa

Abstract

Introduction Tri‐tubular penile fracture is a very rare subset of penile fractures, typically due to high‐energy trauma to the erect penis. Case presentation A 26‐year‐old healthy man presents with a triad of audible crack, immediate detumescence, and hematoma formation, following blunt trauma sustained during vaginal sexual intercourse. A diagnosis of penile fracture is made, with intraoperative finding of a complete traumatic transection of the urethra with total bilateral corpus cavernosa disruption. Both corpora cavernosa were repaired using 2/0 polydioxanone sutures, with the dartos fascia placed in between. The urethra was repaired with interrupted 5/0 polyglactin braided absorbable suture. At 5 weeks, patient reported normal erections and sexual activity with no physical or psychological issues. The literature on management was reviewed. Conclusion Current evidence of surgical management of tri‐tubular penile fractures remains predominantly expert opinion, due to difficulties of conducting prospective trials for a rare condition.

Editorial Comment to Tri‐tubular penile fracture: A case of complete rupture of urethra and bilateral corpus cavernosa

“…3 Young et al reported a case of complete rupture of the urethra and bilateral corpus cavernosa, which could be the most severe type of penile fracture. 4 The gold standard management for penile fractures is immediate surgical repair. 2 The ruptured tunica should be closed with interrupted absorbable sutures via circumcising or a penoscrotal midline incision.…”