An unusual presentation of penile fracture with complete transection of urethra: a case report

Penile fracture is one such urologic emergency that occurs when the penis is struck bluntly during sexual activity, and in less than 5-10% of cases, the concurrent urethral damage is evident, but complete transection is very rare. A 37-year-old male presented with a history of 'snap' sound and immediate detumescence of penis during intercourse, when he fell and hit the pubic bone of his partner. There was acute retention of urine, an attempt to pass a catheter failed and the patient underwent supra-pubic catheterization. On examination, there was classical 'eggplant deformity' of the penis with blood at the tip of the meatus. MRI showed a tunical tear on both sides at the penoscrotal junction with indistinct urethra and extensive hematoma in the proximal penile shaft. Surgical management was successfully done by anastomotic urethroplasty and cavernosal repair.