British Journal
01Urology (1978), SO, 426
Fracture of the Penis Seventy-eight cases of this injury have been previously reported in the Western literature. Case Report A 49-year-old man presented with severe pain in a grossly swollen and deformed penis (Fig.). The patient was unable to micturate spontaneously and there was no urethral bleeding. During intercourse, the patient standing and his wife lying on the bed, the carpet had slipped causing the patient to fall and strike his erect organ against the bed frame. The condition was managed conservatively, except for a suprapubic cystotomy being performed under general anaesthetic to relieve the acute retention. On the second day he micturated spontaneously, and at 2 weeks the catheter was removed and the patient discharged. Five weeks after the accident, his erection was straight and the penis appeared normal except for a “dewlap” on the phrenum caused by oedematous skin. At 6 months, intercourse was normal if less ambitious and the patient was discharged.
Comment Fracture of the penis only occurs if the organ is erect and modes of injury include: blunt trauma, spontaneous occurrence during sexual intercourse, forcibly bending the erection, for example in fending off would be rapists. Treatment can be either conservative or surgical. Thompson (1 954) advocated conservative treatment, operative intervention being required only for drainage of the haematoma if gangrene of the penis threatens. More recently surgical exploration has been encouraged as it allows drainage of the haernatorna and repair of the urethra and Tunica Albuginea (Anderson and Pless, 1976). Acknowledgements We would like to thank Mr R. S. Murley for his wise guidance in managing this case and permission to publish it (also to Dr L. McElwain for his photography, the Department of Medical Illustration, Queen Victoria Hospital, East Grinstead and Mrs J. Weeks for her secretarial assistance).
References Anderson, 9. L. and Pless, J. (1976). Fracture of the Penis. Ugeskr. Loeg., 138, 1034-1035. Thompson, R. F. (1954). Rupture of the Penis. Journal of Urology, 71, 226.
The Authors D. M. Davies, formerly Junior Surgical Staff, St Albans City Hospital, St Albans, Herts. I. Mitchell, St Andrews Hospital, Billericay, Essex.
Fig.
Requests for reprints to: Mr D. M. Davies, FRCS, Queen Victoria Hospital, Holtye Road, East Grinstead, Sussex RH19 3DZ.
426
01Urology (1978), SO, 426
Fracture of the Penis Seventy-eight cases of this injury have been previously reported in the Western literature. Case Report A 49-year-old man presented with severe pain in a grossly swollen and deformed penis (Fig.). The patient was unable to micturate spontaneously and there was no urethral bleeding. During intercourse, the patient standing and his wife lying on the bed, the carpet had slipped causing the patient to fall and strike his erect organ against the bed frame. The condition was managed conservatively, except for a suprapubic cystotomy being performed under general anaesthetic to relieve the acute retention. On the second day he micturated spontaneously, and at 2 weeks the catheter was removed and the patient discharged. Five weeks after the accident, his erection was straight and the penis appeared normal except for a “dewlap” on the phrenum caused by oedematous skin. At 6 months, intercourse was normal if less ambitious and the patient was discharged.
Comment Fracture of the penis only occurs if the organ is erect and modes of injury include: blunt trauma, spontaneous occurrence during sexual intercourse, forcibly bending the erection, for example in fending off would be rapists. Treatment can be either conservative or surgical. Thompson (1 954) advocated conservative treatment, operative intervention being required only for drainage of the haematoma if gangrene of the penis threatens. More recently surgical exploration has been encouraged as it allows drainage of the haernatorna and repair of the urethra and Tunica Albuginea (Anderson and Pless, 1976). Acknowledgements We would like to thank Mr R. S. Murley for his wise guidance in managing this case and permission to publish it (also to Dr L. McElwain for his photography, the Department of Medical Illustration, Queen Victoria Hospital, East Grinstead and Mrs J. Weeks for her secretarial assistance).
References Anderson, 9. L. and Pless, J. (1976). Fracture of the Penis. Ugeskr. Loeg., 138, 1034-1035. Thompson, R. F. (1954). Rupture of the Penis. Journal of Urology, 71, 226.
The Authors D. M. Davies, formerly Junior Surgical Staff, St Albans City Hospital, St Albans, Herts. I. Mitchell, St Andrews Hospital, Billericay, Essex.
Fig.
Requests for reprints to: Mr D. M. Davies, FRCS, Queen Victoria Hospital, Holtye Road, East Grinstead, Sussex RH19 3DZ.
426
