性交後陰莖骨折伴隨部分尿道損傷:病例報告
董劭偉1、胡書維1,2
1台北醫學大學附設雙和醫院 泌尿科，2台北醫學大學 泌尿科
Penile fracture with partial urethral disruption during sexual intercourse: a case report
Shao-Wei Dong1, Su-Wei Hu 1,2
1Department of Urology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
 Figure 1｜penile swelling and discoloration
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2Department of Urology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
 Figure 2｜partial tear of the tunica albuginea of both corpus cavernosum
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 Figure 2｜partial urethral disruption
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Penile fracture is a rare condition. Primarily it is a rupture of the corpus cavernosum that occurs when the penis is erect. The rupture can also affect the corpus spongiosum and the urethra.
We report a case of a 58 year old man who presented with acute penile pain, penile swelling and the inability to pass urine after a blunt trauma during sexual intercourse. In emergency surgery we found bilateral ventral partial rupture of the corpus cavernosum with partial urethral rupture.
Case report
A 58 year old man presented with a sudden cracking sound and acute pain during sexual intercourse followed by rapid detumescence, penile swelling and discoloration (figure 1). Four hours after the penile trauma the patient was admitted to the emergency department.
Physical examination revealed a swollen, ecchymotic penis, blood on the urethral meatus and hematuria was noted. The patient underwent immediate surgical exploration and repair of the fracture.
Circumferential subcoronal degloving incision and hematoma evacuation presented a partial tear of the tunica albuginea of both corpus cavernosum (figure 2). The partial urethral disruption was noted (figure 3). 2-0 vicryl interrupted sutures were used to repair rupture of both corpus cavernosus. 16-F Foley catheter was indwelled in the bladder. Wound was close layer by layer.
A broad spectrum antibiotic were given during the hospital stay. Patient was discharged with foley catheter. We performed urethrography 2 weeks after surgery showed no extravasation and foley was removed.
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