(PM-24) Penile fracture: the role of MRI in diagnosis and targeted surgical management

Abstract Introduction Penile fracture is classically a urological emergency requiring prompt surgical exploration. Diagnosis is typically clinical, and early repair is associated with better outcomes. However, with increasing access to high-resolution imaging (especially MRI) there is growing interest in its role for preoperative planning. Case Presentation We report the case of a 67-year-old man with no prior comorbidities who sustained penile trauma during intercourse. On examination, he presented with penile swelling and ecchymosis. MRI revealed a tear of the tunica albuginea in the right corpus cavernosum, with an adjacent hematoma at the penile base and surrounding edema. Surgical exploration was performed 72 hours post-injury. A 4 cm penoscrotal incision, targeted to the lesion identified on MRI, allowed direct access to the transverse tunical tear and hematoma. The defect was repaired with interrupted 2-0 Vicryl sutures and layered closure. Recovery was uneventful, and the patient resumed sexual activity six weeks later without complications. Discussion While standard management involves complete penile degloving, this case highlights the utility of MRI in guiding a focused, aesthetic approach. MRI enabled precise localization of the injury, allowing a smaller incision and reducing morbidity. Literature supports MRI’s high diagnostic accuracy and its growing role in individualized surgical planning. Conclusion MRI can be a valuable adjunct in selected penile fracture cases, allowing for safe, less invasive, and cosmetically favorable surgical management when timely access is available. Financing No conflict.