Penile fracture with urethral rupture - case report

Introduction Penile fracture is a rupture of the tunica albuginea of the corpus cavernosum caused by an erect penis injury. It is noticed that hematomas always accompany penile fractures. We present a rare case of penile fracture between corpus cavernosus and urethra without hematoma formation. Case Presentation: A 41-year-old male patient presented to the emergency department due to a continuous flow of blood from his urethra, which started an hour earlier due to a penile injury during vigorous sexual intercourse. There was no audible 'snap' sound, but the incident was followed by severe pain and immediate loss of tumescence. His bleeding continued until surgery. No hematoma was observed – Figure 1. A urethrography was performed, and afterward, an experienced urologist inserted a catheter without encountering any resistance. The patient was diagnosed with rupturing the tunica albuginea of the corpus cavernosum and the urethra. No hematoma was found, and primary revision was performed. Urethra and tunica albuginea was sutured. After four weeks catheter was removed. The patient recovered with good uroflowmetry results and did not report erectile dysfunction. Conclusions Rapture of tunica albuginea to the urethra may cause severe bleeding without formation of the hematoma and "eggplant deformity." Therefore, early intervention is crucial to sustain erectile function and avoid urethral stricture.