You appear to be using an old web browser that may not properly display our pages. Our sites are built using standards compliant guidelines that require a more recent web browser such as:

Internet Explorer 6+
FireFox 1+
Netscape 6+

Case of the Month 04/10

This 30 year old male presented to the ED complaining of penile pain and swelling and bleeding from his urethra after sexual intercourse. He was able to void normally.

Question 1: What's wrong with these pictures?

View answer

Answer 1:

There is extravasation of contrast injected during the retrograde urethrogram (circled below). This is significant for urethral tear. This patient had a penile fracture with an associated urethral tear. Most urethral injuries present with gross hematuria, blood at the meatus or inability to void. As patients may present without any of these classic findings, this injury should be ruled out in all cases of penile fracture. (Penile fracture due to tearing of the tunica albuginea typically presents with a popping sound, pain, rapid detumscence and discoloration after trauma to the area usually with intercourse or masturbation.)

Question 2: What is the treatment of this problem?

View answer

Answer 2:

Suspected penile fractures and urethral injuries should undergo prompt surgical evaluation and repair. If the diagnosis is not clinically clear cut, an MRI or ultrasound may be obtained to clarify the type of injury. This patient recovered well after rapid surgical repair.