With sudden rise in the intra cavernosal pressure due to any extrinsic force the already thinned tunica albuginea of the erect penis gives away. Ventral extension of the Buck`s fascia encloses the single corpus spongiosum whereas the dorsal one encloses the two corpora cavernosa. Dorsolaterally there are two corpora cavernosa and the ventromedially there is a corpus spongiosum, each enclosed in tunica albuginea. Discussion Normally inside the penile shaft, erectile tissues are arranged in columnar fashion. Evacuation of hematoma revealing defect in right mid corpus cavernosumģ. Swollen and deformed fractured penisįigure 2. While on prescribed prophylaxis and upon discharge, patient was suggested to abstain from intercourse until complete healing and physiological comfort is attained for routine urological activity.įigure 1. The patient was prescribed antibiotics and a prophylactic urethral catheter was kept for 14 days, which was subsequently removed. A right corporal repair with inverted sutures of prolene 3-0 was performed. The left corpora cavernosa and urethra appeared intact. A ruptured tunica albuginea was found which was about 10 x 8 mm in sized also near the right mid corpora cavernosa hematoma was seen to be localized. The patient was immediately explored under anesthesia. A clinical diagnosis of fractured penis without any obvious urethral injury was made. The urethral meatus was not bloodstained. Clinical examination revealed a swollen, flaccid, blackened penis deviated to one side and there was severe tenderness on palpation. Case Report A 38 years male was brought by her wife to casualty in Vandana Nursing Home & Research Centre with complaints of pain and sudden detumescence of penis while performing coitus. The classic, "textbook" history of penile fracture is a sudden cracking sound as the tunica tears followed by pain, rapid detumescence, swelling and discoloration of the penis with or without voiding problems. proposed that an intracorporal pressure of 1500 mmHg or more during erection can tear the tunica albuginea. 0.25 to 0.5 mm during erection as compared to 2.4 mm in flaccid state. Precisely, it has been observed that tunica albuginea significantly elongates and becomes finer i.e. One of the prominent plausible reasons for the increased risk of penile fracture is the coordinated working physiology of tunica albuginea during shaft erection. Although, tunica albuginea has tensile strength and among the strongest fascia in human organs but at the same time quite prone to disruption, leading to penile fracture. The timely diagnosis followed by immediate surgical exploration and corporoplasty is the need of the hour in such condition. Along with penile fracture, corpora-spongiosal and urethral injuries are also said to exist. Prior infections or injuries in this region make the patient more prone especially if he is using performance-enhancing drugs. Although the most common cause is forced and violent sexual activity, other causes like an accidental injury during sleep are also known to cause this devastating injury. Introduction A sudden unexpected accidental rupture of tunica albuginea and one or both of the corpora cavernosa complexes constitutes an entity called as the penile fracture. In view of clinically critical and underreporting of cases, it is suggestive that prompt urosurgical intervention can preserve the psychological, urophysiological and reproductive functions to lead routine life with restored functions.ġ. In follow up the patient restored with physiological and void functions and regaining normal erectile function. Upon immediate urosurgical attention, we observed severely ruptured tunica albuginea and disrupted corpus cavernosum mediated penile fracture, which was adequately repaired by surgical management. We, hereby, report a case of 38-year-old man who presented with acute penile pain, swelling, distortion of penis and sudden inability to sustain penile erection during normal coitus. However, severity, circumferences and extent of critical injury in penile fracture need to be examined and clinically confirmed on case by case basis. Distinctive to the classic fracture, it is the traumatic tear and/or rupture of corpora cavernosa and tunica albuginea with or without disruptive injury to corpus spongiosum and urethra a coordinating complex responsible for penile erection. Penile fracture is a physiologically rare but clinically critical condition and requires earliest-cum-emergency urosurgical attention.
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