Ruptured corpus cavernosum - penile fracture

Case contributed by Chris O'Donnell
Diagnosis certain

Presentation

Acute pain and swelling in the penis following vigorous sexual intercourse.

Patient Data

Age: 30 years
Gender: Male

Prior to surgical intervention

mri

Penis is held in an abducted position on the anterior abdominal wall.  Small transverse defect in the mid right tunica (arrow) overlying the corpus cavernosum with an adjacent small hematoma (containing methemoglobin given the T1 hyperintensity) and a larger hematoma (arrow) more proximally at the base.  This larger clot extrinsically compresses the corpus and is associated with minor intracavernosal T1 hyperintensity suggesting minor thrmbosis.

Case Discussion

MRI is very useful to define the location, extent and shape (ie transverse or longitudonal) of any tear in the tunica albuginea prior to surgical intervention as well as the location of hematoma that might need draining.  At surgery a small tear was confirmed and repaired on the right.

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