(132) Vertical Fracture of the Penis: A Rare Entity

Abstract Introduction Penile fracture is not an uncommon occurrence. It is a serious injury involving the rupture of the tunica albuginea in the erect state of the penis. While most cases are transverse fractures occurring during coitus, we present a rare case of a “vertical” penile fracture, the second reported in English literature. Objective To document a rare case of penile fracture i.e. a vertical penile fracture and its management. Methods A 33-year-old man presented to the emergency room of the hospital past midnight. He experienced sharp excruciating pain while attempting to penetrate vagina in a rear entry position. He gave a history of popping sound followed by detumescence, and increasing swelling of penis with discoloration and curvature. The pain continued though reduced in severity over time. The patient was evaluated under the guidance of consultant urologist (Author 2). Magnetic resonance imaging reported suspected vertical tear in tunica albugenia and also suspected urethral injury. Results Emergency surgery revealed a vertical long tunica albugenia tear along with corpora spongiosal tear and intact urethral mucosa. The tunica albugenia tear was primarily repaired. Good erectile function was reported by the patient, and normal sexual activity resumed after 6 weeks. Conclusions This case report emphasizes the need for clinicians to be aware of and consider this uncommon entity, “Vertical Tunica Albugenia tear” while managing penile fractures. The utilization of MRI imaging of the penis can provide valuable insights into the pattern and extent of the injury, aiding in appropriate management decision. Surgical intervention within 6–8 hours of the injury offers excellent result and preserves sexual function without complications. Disclosure No.