Complete Urethral Rupture Related with Penile Fracture Occurring during Sexual Intercourse: A Case Report and Review of the Literature

Complete disruption of the urethra due to penile fracture is a very rare occurrence. Herein, we report a case of a 39-year-old man who presented with penile fracture and complete disruption of the urethra as a result of sexual intercourse and present a review of the literature on penile fracture. Surgical exploration at presentation was performed and primary repair was done. In follow-up, the patient reported moderate erectile dysfunction which over time responded to phosphodiesterase-5 inhibitor drugs. Early surgical repair and evaluation for concomitant urethral injury in case of penile fracture is highlighted in this report.

Cinsel İlişki Nedeniyle Oluşmuş Penil Fraktür ile İlişkili Tam Üretral Rüptür: Olgu Sunumu ve Literatür Taraması

Penil fraktür nedeniyle üretranın tam kopması nadiren görülür. Burada, cinsel ilişki sonucu üretra tam kopma ile beraber penil fraktür ile başvuran 39 yaşındaki bir erkek olguyu literatür eşliğinde sunuyoruz. İlk başvuruda hastaya cerrahi eksplorasyon yapıldı ve primer onarım uygulandı. Takipte, hasta fosfodiesteraz-5 inhibitör ilaçlarına cevap veren modarete erektil disfonksiyon bildirdi. Bu olguda, penil fraktür durumunda eşlik eden üretral hasarın değerlendirilmesi ve erken cerrahi onarım vurgulanmıştır.

Kaynakça

Boncher NA, Vricella GJ, Jankowski JT, Ponsky LE, Cherullo EE. Penile fracture with associated urethral rupture. Case Report Med 2010;2010:791948.

Fergany AF, Angermeier KW, Montague DK. Review of Cleveland Clinic experience with penile fracture. Urology 1999;54:352-355.

Tahmaz L, Kilciler M, Gökalp A, Soydan H, Dayanç M, Peker AF. Penis fraktürlü 14 olguda cerrahi tedavi sonuçlarımız. Türk Üroloji Dergisi 2000;26:310312.

Karadeniz T, Topsakal M, Ariman A, Erton H, Basak D. Penil fracture: Differential diagnosis, management and outcome. Br J Urol 1996;77:279281.

Koifman L, Cavalcanti AG, Manes CH, Filho DR, Favorito LA. Penile fractureExperience in 56 cases. Int Braz J Urol 2003;29:35-39.

Kowalczyk J, Athens A, Grimaldi A. Penile fracture: an unusual presentation with lacerations of bilateral corpora cavernosa and partial disruption of the urethra. Urol 1994;44:599-600.

El-Assmy A, El-Tholoth HS, Abou-El-Ghar ME, Mohsen T, Ibrahiem EH. Risk factors of erectile dysfunction and penile vascular changes after surgical repair of penile fracture. Int J Impot Res 2012;24:20-25. Epub 2011 Aug 11.

Lynch D, Martinez-Piñeiro L, Plas E, Serafetinidis E, Turkeri L, Santucci R, Hohenfellner M. Anterior urethral injuries. EAU Guidelines on Urological Trauma 2008;4:44-54.

Ibrahiem el-HI, el-Tholoth HS, Mohsen T, Hekal IA, el-Assmy A. Penile fracture: long-term outcome of immediate surgical intervention. Urology 2010;75:108-111.

Soylu A, Yilmaz U, Davarci M, Baydinc C. Bilateral disruption of corpus cavernosum with complete urethral rupture. Int J Urol 2004;11:811-812.

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