Penile Fractures: Symptoms, Treatment, and Diagnosis - Urology

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Penile fractures, although relatively rare, can occur during sexual intercourse or other activities that involve trauma to the penis. This injury typically involves a rupture of the tunica albuginea, the fibrous sheath surrounding the erectile tissue, and can lead to significant pain, swelling, and sometimes deformity. Understanding the symptoms, diagnosis, and treatment options is crucial for anyone who suspects they may have sustained such an injury.


Symptoms of Penile Fractures
The primary symptoms of a penile fracture include:
1. Sudden Pain: A sharp pain is usually felt immediately at the time of injury.

2. Swelling and Bruising: The area may become swollen and bruised shortly after the injury.

3. Deformity: In some cases, the penis may appear bent or misshapen.

4. Difficulty with Erection: There may be difficulty achieving or maintaining an erection following the injury.

5. Hematuria: Blood in the urine can occur if there is associated injury to the urethra.


Diagnosis
Diagnosis of a penile fracture typically involves a thorough medical history and physical examination. In cases where the injury is not visually apparent, imaging studies may be necessary. The following diagnostic tools can be utilized:
1. Ultrasound: This non-invasive imaging technique can help visualize the internal structures of the penis and identify any tears in the tunica albuginea.

2. MRI: Magnetic resonance imaging can provide detailed images of soft tissue and may be used to assess the extent of the injury.

3. CT Scan: A computed tomography scan can also be helpful in evaluating the injury, especially if there is concern about associated injuries to the surrounding structures.


Treatment Options
The treatment for a penile fracture largely depends on the severity of the injury. In many cases, surgical intervention is required, especially if there is a significant rupture or if the injury is associated with urethral damage. Here are the common treatment approaches:
1. Conservative Management: If the injury is minor and there are no signs of significant internal damage, conservative treatment may include rest, ice application, and the use of anti-inflammatory medications to manage pain and swelling.

2. Surgery: If there is a complete rupture of the tunica albuginea or if there are complications such as urethral injury, surgical repair is often necessary. The surgery typically involves suturing the torn tissue and may also involve repairing any associated urethral injuries.

3. Follow-Up Care: Post-operative care is crucial for recovery. This may include avoiding sexual activity for a specified period, pain management, and regular follow-up appointments to monitor healing.


When to Seek Further Medical Attention
Given that you have been experiencing persistent pain for nearly two months after the injury, it is essential to seek further medical evaluation. If the initial treatments have not alleviated your symptoms, you may need to consult a urologist who specializes in penile injuries. They can perform the necessary imaging studies to determine if there is any internal damage that requires surgical intervention.

In summary, while penile fractures can be painful and concerning, appropriate diagnosis and treatment can lead to a successful recovery. If you suspect that your injury may be more severe than initially thought, do not hesitate to seek a second opinion or request further diagnostic testing to ensure that any potential complications are addressed promptly.