Penile fracture with complete urethral rupture: case report and literature review

Introduction: Penile fracture is a rare urological emergency characterized by the rupture of the tunica albuginea, commonly associated with trauma to one or both corpora cavernosa. In severe cases, additional damage to the corpus spongiosum and urethra can occur. Immediate surgical intervention is crucial for optimal recovery, reducing complications such as erectile dysfunction and urethral strictures. Objective: To present a rare case of penile fracture involving both corpora cavernosa and complete urethral rupture, managed surgically. A brief literature review is also included. Case Report: A 33-year-old male presented to the emergency department after hearing a snapping sound during sexual intercourse, followed by detumescence, urethrorrhagia, and penile pain. Initial misdiagnosis led to a delayed referral, at which point imaging confirmed bilateral fractures of the corpora cavernosa and complete urethral rupture. Surgical exploration revealed complete penile urethral avulsion. The patient underwent successful primary urethral anastomosis and repair of the tunica albuginea, followed by an uneventful postoperative recovery. At follow-up, the patient reported no urinary issues, preserved erectile function, and normal sexual activity. Discussion: The diagnosis of penile fracture is primarily clinical, often associated with sudden detumescence, penile deviation, and urethral bleeding. Imaging, such as ultrasonography or MRI, assists in confirming the diagnosis and identifying associated injuries. Immediate surgical repair is the treatment of choice, offering better functional outcomes compared to conservative management. In this case, early surgical intervention resulted in complete recovery without complications. Conclusion: Penile fracture with bilateral corporal injury and urethral rupture is a rare but challenging condition. Prompt diagnosis and early surgical repair are essential for favorable outcomes, as demonstrated in this case.