Urogenital Imaging

Fracture, penile

injury to the tunica albuginea, appearing as an acquired curvature of the penis. It is most often caused by a lateral buckling trauma, occurring during sexual intercourse. Most patients present with a history of minimal lateral curvature of the penis and of hearing a "snap" during intercourse. They also commonly report immediate detumescence and marked ecchymosis of the penis. Most patients present in the acute setting, and reconstruction can be performed at that time. In some patients, there is no clear antecedent trauma, and these affected individuals present instead with a lateral scar that causes lateral indentation of the penis and, in some cases, curvature as well.

A subclinical fracture of the penis is seen when the outer longitudinal layer of the tunica albuginea is disrupted during buckling trauma, but the inner, circular layer remains intact. Alternatively, both layers may be disrupted, but the closely applied Buck's fascia remains intact. In either case, the corpus cavernosum remains continuous, and the symptoms of detumescence and ecchymosis are not commonly present.

Diagnosis is based on clinical history and physical examination, and the treatment is surgical reconstruction. Radiological imaging plays no significant clinical role.

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