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Penile fracture: Penoscrotal approach with degloving of penis after Magnetic Resonance Imaging (MRI)

Gabriele Antonini, Patrizio Vicini, Salvatore Sansalone, Giulio Garaffa, Antonio Vitarelli, Ettore De Berardinis, Magnus Von Heland, Riccardo Giovannone, Emanuele Casciani, Vincenzo Gentile
  • Gabriele Antonini
    Department of Urology, “Sapienza” Rome University, Rome, Italy
  • Patrizio Vicini
    Department of Urology, “I.N.I.” Italian Neurotraumatologic Institute Grottaferrata, Rome, Italy | patriziovicini@gmail.com
  • Salvatore Sansalone
    Department of Experimental Medicine and Surgery, “Tor Vergata” Rome University, Rome, Italy
  • Giulio Garaffa
    Department of Experimental Medicine and Surgery, “Tor Vergata” Rome University, Rome, Italy
  • Antonio Vitarelli
    Department of Urology, Bari University, Bari, Italy
  • Ettore De Berardinis
    Department of Urology, “Sapienza” Rome University, Rome, Italy
  • Magnus Von Heland
    Department of Urology, “Sapienza” Rome University, Rome, Italy
  • Riccardo Giovannone
    Department of Urology, “Sapienza” Rome University, Rome, Italy
  • Emanuele Casciani
    Department of Radiology, “Sapienza” Rome University, Rome, Italy
  • Vincenzo Gentile
    Department of Urology, “Sapienza” Rome University, Rome, Italy

Abstract

Fracture of the penis, a relatively uncommon emergency in Urology, consists in the traumatic rupture of the tunica albuginea of the corpus cavernosum. Examination and clinical history can be highly suspicious of penile fracture in the majority of cases and ultrasonography (USS) can be useful to identify the exact location of the tunical rupture, which is proximal in 2/3 of cases and therefore manageable through a penoscrotal approach. Although expensive and not readily available in the acute setting, Magnetic Resonance Imaging (MRI) may play a role in the differential diagnosis with rupture of a circumflex or dorsal vein of the penis or when the tunical rupture is not associated with tear of the overlying Buck’s fascia. This form of imaging is more sensitive than USS at identifying the presence of a tunical tear. The treatment of choice is immediate surgical repair, which allows preserving erectile function and minimizing corporeal fibrosis.

Keywords

Penile fracture; Magnetic Resonance Imaging (MRI); Ultrasonography; Fibrosis; Erectile dysfunction

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Submitted: 2014-03-28 11:50:16
Published: 2014-03-28 00:00:00
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Copyright (c) 2014 Gabriele Antonini, Patrizio Vicini, Salvatore Sansalone, Giulio Garaffa, Antonio Vitarelli, Ettore De Berardinis, Magnus Von Heland, Riccardo Giovannone, Emanuele Casciani, Vincenzo Gentile

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