Delayed Presentation and Surgical Intervention of Accidental Non-sex Related Penile Fracture with Urethral Injury: A Case Report

Abstract

Penile fracture is a rare and unusual pathology resulting from a tear of the tunica albuginea of an erect penis. It is typically associated with sexual intercourse, masturbation, and a fall on or rolling over an erect penis. A cracking or popping sound followed by acute pain, rapid detumescence, and swelling of the penile shaft are frequent presenting symptoms. Prompt surgical intervention with repair of the tunica albuginea tear is the treatment of choice with satisfactory cosmetic and functional results. We report the case of a 38-year-old man who presented to our urology outpatient clinic with a twenty-three-day history of penile trauma resulting from a forceful attempt to pull out his erect penis to urinate. Immediate penile exploration was performed following a diagnosis of penile fracture. He was found to have a tear of the tunica albuginea of the right corpora cavernosa with a urethral injury which was repaired successfully. This case of atypical aetiology, delayed presentation, and surgical intervention of penile fracture highlights the importance of maintaining a high index of suspicion in diagnosing this rarecondition, even in the absence of a typical mechanism of injury, in order to ensure that such injury is not missed.