A rare urological emergency that warrants prompt surgical intervention.
Traumatic rupture of corpus cavernosa and tunica albuginea in an erect penis.
The tunica albuginea is around 2mm in flaccid, but 0.5mm in erect.
Pressure of up to 1500mmHG in corpus cavernosa from bending through blunt trauma can result in rupture.
Blunt trauma as penis is violently deviated away from its axis.
Penetrative intercours with partner on top
Falling from bed with erect penis
Forceful correction of congenital chorde
History of trauma
Popping sensation or hearing a snap
Immediate pain, swelling and detumescence
Penile swelling and discolouration called aubergine sign.
Potential deviation away from the lesion
A firm immobile haematoma in the perineum can suggest urethral injury.
Should have routine pre-op bloods
Cavernosography can be used in cases of suspected penile fracture or in delayed presentation
If tehre is concurrent urethral injury retrograde urethography should be performed.
Analgesia and anti-emetics before urgent surgical exploration and repair
Circumferential incision arnd the penis skin is de-gloved proximally.
The haematoma should be evacuated before the tear is identified and repair with absorbable sutures.
Abstinence from all sexual activities for 6-8 weeks should be done