title: Sex-related penile fracture with complete urethral rupture: A case report and review of the literature.
abstract: OBJECTIVE
  To present the management of a patient with partial disruption of both cavernosal bodies and complete urethral rupture and to propose a non-systematic review of literature about complete urethral rupture. MATERIAL AND METHOD - CASE REPORT: A 46 years old man presented to our emergency department after a blunt injury of the penis during sexual intercourse. On physical examination there was subcutaneous hematoma extending over the proximal penile shaft with a dorsal-left sided deviation of the penis and urethral bleeding. Ultrasound investigation showed an hematoma in the ventral shaft of the penis with a discontinuity of the tunica albuginea of the right cavernosal corporum. The patient underwent immediate emergency surgery consisted on evacuation of the hematoma, reparation the partial defect of both two cavernosal bodies and end to end suture of the urethra that resulted completely disrupted.
  
  
  RESULTS
  The urethral catheter was removed at the 12-th postoperative day without voiding symptoms after a retrograde urethrography. 6 months postoperatively the patients was evaluated with uroflowmetry demonstrating a max flow rate of 22 ml/s and optimal functional outcomes evaluated with validated questionnaires. 8 months after surgery the patients was evaluated by dynamic magnetic resonance (MRI) of the penis showing only a little curvature on the left side of the penile shaft.
  
  
  CONCLUSIONS
  Penile fracture is an extremely uncommon urologic injury with approximately 1331 reported cases in the literature till the years 2001. To best of our knowledge from 2001 up today, 1839 more cases have been reported, only in 159 of them anterior urethral rupture was associated and in only 22 cases a complete urethral rupture was described. In our opinion, in order to prevent long term complications, in case of clinical suspicion of penile fracture, especially if it is associated to urethral disruption, emergency surgery should be the first choice of treatment.
authors.affiliation: Department of Urology, University of Bologna, S.Orsola-Malpighi Hospital, Bologna. marco.garofalo@unibo.it.
authors.forename: Marco
authors.initials: M
authors.lastname: Garofalo
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Bianchi
authors.forename: Giorgio
authors.initials: G
authors.lastname: Gentile
authors.forename: Marco
authors.initials: M
authors.lastname: Borghesi
authors.forename: Valerio
authors.initials: V
authors.lastname: Vagnoni
authors.forename: Hussam
authors.initials: H
authors.lastname: Dababneh
authors.forename: Riccardo
authors.initials: R
authors.lastname: Schiavina
authors.forename: Alessandro
authors.initials: A
authors.lastname: Franceschelli
authors.forename: Daniele
authors.initials: D
authors.lastname: Romagnoli
authors.forename: Fulvio
authors.initials: F
authors.lastname: Colombo
authors.forename: Beniamino
authors.initials: B
authors.lastname: Corcioni
authors.forename: Rita
authors.initials: R
authors.lastname: Golfieri
authors.forename: Eugenio
authors.initials: E
authors.lastname: Brunocilla
mesh_terms: D003075:Coitus; D004630:Emergencies; D004638:Emergency Treatment; D006406:Hematoma / Q000209:etiology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D010413:Penis / Q000293:injuries* / Q000601:surgery; D012421:Rupture; D016896:Treatment Outcome; D014521:Urethra / Q000293:injuries* / Q000601:surgery; D013521:Urologic Surgical Procedures, Male / Q000379:methods; D014949:Wounds, Nonpenetrating / Q000150:complications* / Q000601:surgery