Penile Fracture

Abstract

Penile fracture is a real urological emergency and underreported¹ due to the shyness to describe it therefore it leads to complications like erectile dysfunction later on. Penile fracture is defined as fracture of the tunica albuginea of copus cavernosum of penis due to blunt trauma to erect penis.² Because it is a relatively rare emergency, our colleagues may not be knowing much of its details. The purpose of this review is to introduce this subject in a concise and simple manner so that problem may be identified early and get its prompt management done at some specialized center. Conservative management (delaying the management) may lead to devastating functional, physical and psychological complications.³Penis is composed of two corporal bodies, corpora cavernosa are joined by a septum and a corpus spongiosum investing the urethra.⁴ Corpus cavernosum is surrounded by tunica albuginea containing sinusoids in it. These sinusoids fill with blood during erection. This blood comes through internal pudendal artery. Tunica albuginea is a layer which is 0.5 mm thick when stretched during erection and it is 2 mm thick when penis is flaccid.  Both the corpora cavernosa are invested in Buck’s fascia. Between the tunica albuginea and buck’s fascia run the neuro-vascular bundle typically at 2 and 10 o’clock position. Outside the Buck’s fascia is the layer of dartos fascia and outer to it is the skin. Dorsal to both corpora cavernosa runs the urethra invested in corpus spongiosum to exit through the external urethral meatus. Glans is the distal expansion of the corpus spongiosum.Proximally both the corpora cavenosa are attached with pubic bone and distally they end at glans penis. The loose skin of prepuce normally covers the glans of an uncircumcised patient.