Case Report: Management of Penile Fracture with Urethral Injury in Two Patients

Penile fracture is a trauma accompanied by sudden pain, swelling, loss of erection, deviation, and ecchymosis along with a breaking sound in the penis. It can be accompanied by urethral injuries in 11-22% of patients, occurring due to force/blunt trauma to the erect penis. In this case report, we present two cases of penile fracture with accompanying urethral injury, occurring approximately one month apart. In our first case, surgical repair was performed approximately 1 hour after the incident, and in the second case, it was performed approximately 2 hours after the incident. Ultrasound (USG) was used as radiological imaging in both cases. In the second case, suspicion of urethral injury was mentioned in the USG. In both cases, a subcoronal circumferential incision was made, and the penile skin was degloved up to the radix. Damaged areas in the intraoperative tunica albuginea and urethra were observed in both cases. Postoperatively, the penile bandage of the first case was removed on the 4th day, and that of the second case was removed on the 6th day. The catheter was removed on the 20th day in both cases. In both cases, no loss of erection or penile deviation was observed at the 3-month postoperative follow-up. No clinical or uroflowmetric findings compatible with urethral stenosis were found in the 2nd and 3rd months post-op. The current approach to penile fractures is emergency surgical decompression and repair.