We Urologists also treat fractures
A penile fracture is an injury caused by the rupture of the tunica albuginea, which is a tough cover enveloping the corpus cavernosum penis.This distressing rupture is a rare urological emergency which happens only when a man has an erection. The most common cause, accounting for about 60% – 70% of cases, it is intercourse and especially, Woman on top position resulting in impact against the female pelvis or perineum and bending laterally of the erect penis which may cause the fracture. Other causes can be aggressive masturbation, physical manipulation of the penis to remove the erection or at night when nocturnal tumescence occurs. The patient will complain of a popping or cracking sound, a significant pain, immediate detumescence, and skin hematoma of various sizes on the penis. The urethra might be injured in about 20% cases in which the patient will also complain passage of blood per urethra or retention of urine.
Normally a history suggestive of and clinical examination can clinch the diagnosis but in certain cases ultrasonography or cavarsography might be necessary. Fracture penis is an emergency and should be treated surgically immediately. Surgery involves removal of hematoma and repair of the tunica albuginea covering the corpora cavernosum. Delay in seeking treatment increases the complication rate up to 50% in the form of erectile dysfunction, a permanent curvature of the penis, damage to the urethra or pain during intercourse.