Isolated Urethral Injury Following Sexual Intercourse-related Penile Trauma without Corporal Involvement: A Case Report

Blunt penile trauma during sexual intercourse commonly results in penile fracture with disruption of the tunica albuginea and corpora cavernosa. Isolated urethral injury without associated corporal involvement is exceedingly rare. Hereby, the authors present a case of a 35-year-old male presenting with recurrent bleeding per urethra during erection following blunt penile trauma during sexual intercourse in missionary position. Clinical examination, ultrasonography, and cystoscopic evaluation demonstrated an isolated long anterior urethral submucosal tear without disruption of the tunica albuginea, corpora cavernosa, or corpus spongiosum. The patient had no history of audible cracking sound, immediate detumescence, penile deformity, or urinary retention suggestive of classical penile fracture. He was managed conservatively with urethral catheterisation for 15 days with complete resolution of symptoms. At three-month follow-up, the patient remained asymptomatic with satisfactory voiding and no erectile dysfunction. The present case highlights the importance of maintaining high clinical suspicion for isolated urethral injury even in the absence of classical signs of penile fracture. Conservative management with catheterisation alone may be successful in carefully selected patients with preserved urethral continuity.