[Rupture of the corpora cavernosa: its therapeutic assessment and management].
BACKGROUND
The traumatic rupture of cavernous bodies is an uncommon condition that always takes place with an erected penis, the most frequent etiology being an untimely vaginal intercourse, due to the greater vulnerability of the penis in such situation, resulting from contained trauma by direct external forces. The distinctive presenting signs are a "snap", immediate detumescence, pain, deformity, bruise and deviation contralateral to the lesion. The bruises will be limited to the penis in the presence of Buck's fascia integrity. This paper contributes one case of rupture of right cavernous body, explaining its typical etiology, signs and symptoms, and examination of the patients who underwent emergency surgery.


METHODS
27-year-old patient who turns up into the emergency service with penile haematoma and local pain, reporting an earlier snap and detumescence. The examination reveals a hose-type haematoma with a "wringer" mark. The ultrasound shows haematoma, albuginea interruption and Buck's fascia integrity. The patient undergoes emergency surgery that involves whole penis denudation, haematoma evacuation and suture of impaired cavernous body. No incidence is reported during the post-operative. The patient is now asymptomatic and holds successful erections.


CONCLUSIONS
The differential diagnosis should be done versus rupture of the penis dorsal vein, which causes identical signs and symptoms. NMR is considered as the best imaging test, although is still quite unaffordable. Standard ultrasounds do not rule out the diagnosis. Under suspicion of associated urethral damage, retrograde urethrography is warranted. Cavernosonography has very specific indications and should be avoided whenever possible. Choice treatment will be emergency revision and surgical repair. Suture of involved cavernous body must be done with loose stitches of absorbable material. Antibiotic prophylaxis is indicated in cases of concomitant urethral involvement.
Lorenzo Romero
J G
JG
Servicio de Urología, Hospital General de Albacete.
Segura Martín
M
M
Salinas Sánchez
M
M
Pastor Guzmán
J M
JM
Hernández Millán
I
I
Martínez Martín
M
M
Virseda Rodríguez
J A
JA
D000328:Adult; D003075:Coitus; D003937:Diagnosis, Differential; D004630:Emergencies; D006406:Hematoma / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D006801:Humans; D008297:Male; D010409:Penile Diseases / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D010410:Penile Erection; D010413:Penis / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D012421:Rupture / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D014463:Ultrasonography